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Presentation With Lower Cranial Nerve Palsies

Bahram Mokri, MD; Wouter I. Schievink, MD; Kerry D. Olsen, MD; David G. Piepgras, MD

Arch Otolaryngol Head Neck Surg. 1992;118(4):431-435.

Abstract
• Spontaneous dissections of the internal carotid arteries are uncommon but are not rare. They constitute a fairly common cause of ischemic stroke in young patients (young in terms of the age at which strokes generally occur). The common presenting manifestations are (1) unilateral headaches followed after a period of delay by focal cerebral ischemic symptoms or (2) unilateral headaches and ipsilateral incomplete Horner's syndrome. These may or may not be associated with subjective or objective bruits. In rare instances, spontaneous dissections of the internal carotid arteries may present as lower cranial nerve palsies and cause dysphonia, dysarthria, dysphagia, and numbness of the throat. Affected patients may initially present to the otolaryngologist or be referred to one. This article describes eight patients with spontaneous dissections of the internal carotid arteries and lower cranial nerve palsies, and the pertinent literature is reviewed.

(Arch Otolaryngol Head Neck Surg. 1992;118:431-435)

Author Affiliations
From the Departments of Neurology (Dr Mokri), Neurologic Surgery (Drs Schievink and Piepgras), and Otorhinolaryngology (Dr Olsen), Mayo Clinic and Mayo Foundation, Rochester, Minn.

Footnotes
Accepted for publication October 17, 1991.

Reprint requests to Department of Neurology, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (Dr Mokri).

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