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Diagnostic Value of Preoperative Electrodiagnostic Analysis in a Patient with Facial Palsy and a Large Vestibular Schwannoma: Case Report

Although radiologic methods confirm the diagnosis of patients with large vestibular schwannomas, these methods usually indicate only the size of the tumor and its possible nerve compression. Electrodiagnostic methods can reveal the functional state of the nerves, particularly the trigeminal and faci...

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Autor principal: Yoo, Myung Chul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8871403/
https://www.ncbi.nlm.nih.gov/pubmed/35204631
http://dx.doi.org/10.3390/diagnostics12020542
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author Yoo, Myung Chul
author_facet Yoo, Myung Chul
author_sort Yoo, Myung Chul
collection PubMed
description Although radiologic methods confirm the diagnosis of patients with large vestibular schwannomas, these methods usually indicate only the size of the tumor and its possible nerve compression. Electrodiagnostic methods can reveal the functional state of the nerves, particularly the trigeminal and facial nerves, as well as providing a basis for objectively evaluating nerve injury. Due to the lack of an established objective evaluation method, electrodiagnostic methods were utilized to assess injury to the cranial nerve in a patient with a large vestibular schwannoma. A 79-year-old woman presented with a one-month history of right facial palsy, vertigo, dizziness, right postauricular pain, and right-sided hearing disturbance. Physical examination suggested injuries to the facial and vestibulocochlear nerves. Magnetic resonance imaging identified a vestibular schwannoma and showed that the tumor mass was affecting the brainstem, including the fourth ventricle, resulting in mild obstructive hydrocephalus. Preoperative electrodiagnostic evaluation identified asymptomatic trigeminal neuropathy accompanying a vestibular schwannoma. The patient underwent surgery, consisting of a suboccipital craniotomy with additional gamma knife radiosurgery. Postoperatively, she demonstrated significant recovery from right facial palsy and partial improvement of her neurologic symptoms. Large vestibular schwannomas with facial paralysis may be accompanied by additional entrapment neuropathy. Routine preoperative electrophysiological evaluation is recommended to establish a definitive diagnosis and evaluate the function of the trigeminal nerve, facial nerve, and brainstem in patients with large and compressive vestibular schwannomas.
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spelling pubmed-88714032022-02-25 Diagnostic Value of Preoperative Electrodiagnostic Analysis in a Patient with Facial Palsy and a Large Vestibular Schwannoma: Case Report Yoo, Myung Chul Diagnostics (Basel) Case Report Although radiologic methods confirm the diagnosis of patients with large vestibular schwannomas, these methods usually indicate only the size of the tumor and its possible nerve compression. Electrodiagnostic methods can reveal the functional state of the nerves, particularly the trigeminal and facial nerves, as well as providing a basis for objectively evaluating nerve injury. Due to the lack of an established objective evaluation method, electrodiagnostic methods were utilized to assess injury to the cranial nerve in a patient with a large vestibular schwannoma. A 79-year-old woman presented with a one-month history of right facial palsy, vertigo, dizziness, right postauricular pain, and right-sided hearing disturbance. Physical examination suggested injuries to the facial and vestibulocochlear nerves. Magnetic resonance imaging identified a vestibular schwannoma and showed that the tumor mass was affecting the brainstem, including the fourth ventricle, resulting in mild obstructive hydrocephalus. Preoperative electrodiagnostic evaluation identified asymptomatic trigeminal neuropathy accompanying a vestibular schwannoma. The patient underwent surgery, consisting of a suboccipital craniotomy with additional gamma knife radiosurgery. Postoperatively, she demonstrated significant recovery from right facial palsy and partial improvement of her neurologic symptoms. Large vestibular schwannomas with facial paralysis may be accompanied by additional entrapment neuropathy. Routine preoperative electrophysiological evaluation is recommended to establish a definitive diagnosis and evaluate the function of the trigeminal nerve, facial nerve, and brainstem in patients with large and compressive vestibular schwannomas. MDPI 2022-02-20 /pmc/articles/PMC8871403/ /pubmed/35204631 http://dx.doi.org/10.3390/diagnostics12020542 Text en © 2022 by the author. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Yoo, Myung Chul
Diagnostic Value of Preoperative Electrodiagnostic Analysis in a Patient with Facial Palsy and a Large Vestibular Schwannoma: Case Report
title Diagnostic Value of Preoperative Electrodiagnostic Analysis in a Patient with Facial Palsy and a Large Vestibular Schwannoma: Case Report
title_full Diagnostic Value of Preoperative Electrodiagnostic Analysis in a Patient with Facial Palsy and a Large Vestibular Schwannoma: Case Report
title_fullStr Diagnostic Value of Preoperative Electrodiagnostic Analysis in a Patient with Facial Palsy and a Large Vestibular Schwannoma: Case Report
title_full_unstemmed Diagnostic Value of Preoperative Electrodiagnostic Analysis in a Patient with Facial Palsy and a Large Vestibular Schwannoma: Case Report
title_short Diagnostic Value of Preoperative Electrodiagnostic Analysis in a Patient with Facial Palsy and a Large Vestibular Schwannoma: Case Report
title_sort diagnostic value of preoperative electrodiagnostic analysis in a patient with facial palsy and a large vestibular schwannoma: case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8871403/
https://www.ncbi.nlm.nih.gov/pubmed/35204631
http://dx.doi.org/10.3390/diagnostics12020542
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