Wegener’s Granulomatosis presenting with multiple cranial neuropathies.

M. Lowden, Aiesha Ahmed
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Abstract

A 41 �year-old man had headaches, hearing loss, and left facial palsy for five months. Examination was remarkable for left seventh nerve palsy, left sided hearing loss and hemi tongue atrophy. MRI showed left cerebellopontine angle dural thickening.(Figure1and 2). Laboratory studies (CSF and blood) were unremarkable for an infectious, neoplastic and autoimmune etiology except for an elevated Antineutrophil cytoplasmic antibody titer. A dural biopsy showed chronic inflammation with granuloma formation. He was started on prednisone with plans to start immunosuppresants as outpatient.
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韦格纳肉芽肿病表现为多发性颅神经病变。
一名41岁的男性患有头痛、听力丧失和面部麻痹5个月。左侧第七神经麻痹、左侧听力丧失、半舌萎缩等表现显著。MRI显示左脑桥小脑角硬脑膜增厚。(图1和图2)。除了抗中性粒细胞细胞质抗体滴度升高外,实验室研究(脑脊液和血液)对感染性、肿瘤性和自身免疫性病因无明显影响。硬脑膜活检显示慢性炎症伴肉芽肿形成。他开始服用强的松,并计划在门诊开始使用免疫抑制剂。
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