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Cysticercosis of the central nervous system: less frequent clinical forms. II - Forms of the cerebellopontine angle

The localization of cysticerci in the lateral recess of the cisterna pontis may bring about a cerebello-pontine angle syndrome, eventually simulating a neurinoma of the nervus acusticus. The authors made a review of such cases reported in the literature. The differential diagnosis with the neurinomas of the auditory nerve is discussed under the clinical and radiological viewpoints. The authors report 7 cases of cysticercosis of the cerebello-pontine angle. The etiologic diagnosis was established in 5 cases by a positive complement fixation test for cysticercosis in the cerebrospinal fluid, and by surgery and/or postmortem examination in 2. All the cases showed symptoms of cochlear involvement, bilateral in 2; in 4 cases there was a vestibular impairment. Signs of unilateral involvement of the trigeminal nerve occurred in 6 cases. Facial nerve paralysis was present in 4 cases. Three patients had pharynx paralysis and 2, internal strabismus. In 3 cases the absence of cerebellar signs would suggest the diagnosis of neurinoma of the nervous acusticus if it were not for the clinical and subsidiary data, which pointed to neurocysticercosis. Signs of intracranial hypertension were evident in 5 patients. Convulsions occurred in 2 cases. Commenting on the results of radiological examination the authors emphasize that, in one case, there was an amputation of the tip of the petrous pyramid ipsilateral to the cerebello-pontine angle syndrome; other data, however, led the authors to reject the hypothesis of a neurinoma of the nervous acusticus, and the surgeon actually recovered a racemose cysticercus from the lateral recess of the cisterna pontis.


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