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Cranial nerve palsies in typhoid fever: report of three cases

N Joshi1, M Bhattacharya, S Yadav

  • 1Department of Paediatrics, Maulana Azad Medical College & Lok Nayak Hospital, New Delhi, India.

Annals of Tropical Paediatrics
|July 26, 2011
PubMed

Insights

Neurological complications of enteric fever, like cranial nerve palsies, are known but rare. This study reports three children with typhoid fever who developed palatal or sixth cranial nerve palsies, which resolved with treatment.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Pediatrics

Background:

  • Enteric fever, primarily caused by Salmonella Typhi, can present with diverse neurological complications.
  • While central nervous system involvement is common, isolated cranial nerve palsies are infrequently reported.
  • The spectrum of neurological sequelae requires continuous investigation for comprehensive understanding.

Observation:

  • Three pediatric cases of culture-proven typhoid fever were analyzed.
  • Two patients presented with palatal palsy, a rare manifestation.
  • One patient developed isolated sixth cranial nerve palsy, a previously unreported association with typhoid.

Findings:

  • All three children experienced isolated cranial nerve palsies secondary to typhoid fever.
  • Palatal palsy occurred in two patients, and sixth cranial nerve palsy in one.
  • Complete resolution of neurological deficits was observed within 5-7 weeks post-treatment.

Implications:

  • This study highlights the potential for rare neurological presentations of typhoid fever in children.
  • It underscores the importance of considering enteric fever in the differential diagnosis of unexplained cranial nerve palsies.
  • Further research may elucidate the specific mechanisms underlying these neurological manifestations and inform clinical management.

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