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Facial palsy as an unusual presenting symptom associated with acute myeloid leukemia

Kazuo Kubota1, Michio Ozeki, Tomohiro Hori

  • 1Department of Pediatrics, Gifu University Graduate School of Medicine, Gifu, Japan.

Pediatrics International : Official Journal of the Japan Pediatric Society
|September 25, 2014
PubMed

Insights

Facial palsy in a child can rarely signal acute myeloid leukemia (AML). Enhanced MRI confirmed facial nerve infiltration by AML, which resolved with chemotherapy, highlighting AML as a crucial differential diagnosis.

Area of Science:

  • Pediatric Hematology Oncology
  • Neurology
  • Diagnostic Imaging

Background:

  • Extramedullary infiltration is a known complication of acute myeloid leukemia (AML).
  • Neurological symptoms can occur in AML, but facial palsy as a presenting sign is uncommon.
  • Early diagnosis and treatment are critical for improving outcomes in pediatric AML.

Observation:

  • A 1-year-old boy presented with right-sided facial palsy.
  • Diagnostic workup revealed acute myeloid leukemia, French-American-British classification M1.
  • Magnetic resonance imaging (MRI) with gadolinium contrast demonstrated abnormal enhancement of the affected facial nerve.

Findings:

  • The abnormal facial nerve enhancement on MRI indicated leukemic infiltration.
  • Chemotherapy led to the complete resolution of the facial nerve enhancement.
  • This case demonstrates a rare but significant neurological manifestation of AML.

Implications:

  • Acute myeloid leukemia should be considered in the differential diagnosis of pediatric facial palsy.
  • Enhanced MRI is a valuable tool for diagnosing facial nerve involvement in AML.
  • Imaging can effectively monitor treatment response in extramedullary AML infiltration.
Keywords:
acute myeloid leukemiaextramedullary infiltrationfacial palsytrisomy 8

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