Rinsho Shinkeigaku (Clinical Neurology)

Brief Clinical Note

Acute myeloid leukemia diagnosed by dysphagia due to bilateral vagus nerve palsy: a case report

Taiji Mukai, M.D.1), Kenichi Sakuta, M.D., Ph.D.1), Kei Hirano, M.D.2), Kazuhito Suzuki, M.D., Ph.D.2), Kaichi Nishiwaki, M.D., Ph.D.2) and Hiroshi Yaguchi, M.D., Ph.D.1)

1) Department of Neurology, The Jikei University Kashiwa Hospital
2) Division of Clinical Oncology/Hematology, The Jikei University Kashiwa Hospital

This is the rare case report that bilateral vagus nerve paralysis was emerged as the initial symptom of acute myelogenous leukemia (AML). An 83-year-old man admitted to our hospital because of dysphagia. His dysphagia progressed two months prior to admission. Although physical examination revealed no abnormality, videoendoscopy and videofluorography examination clearly revealed bilateral vagus nerve palsy. Brain MRI showed hypointense signals at the bilateral clivus on T1 weighted images, suggesting tumor infiltration to bilateral petroclivus. He was diagnosed as AML by blood samples and bone marrow biopsy. After initiation of the treatment including radiation therapy, dysphagia shows mild improvement. Although bilateral cranial nerve palsy due to malignant tumor involving at the clivus is very uncommon, we should pay attention to the symptom.
Full Text of this Article in Japanese PDF (2048K)

(CLINICA NEUROL, 60: 504−507, 2020)
key words: acute myeloid leukemia, clivus metastasis, bilateral vagus nerve palsy

(Received: 3-Feb-20)