Multiple Cranial Nerve Palsies in Giant Cell Arteritis.

Area of Science:

• Neurology
• Rheumatology
• Ophthalmology

Background:

• Giant cell arteritis (GCA) is a systemic vasculitis affecting medium and large arteries.
• Ophthalmic complications are common in GCA, including ischemic optic neuropathy and cranial nerve palsies.
• Cranial nerve palsies in GCA typically affect one nerve and occur in 2-15% of patients.

Observation:

• This report details two patients diagnosed with biopsy-proven GCA.
• Both patients presented with multiple cranial nerve palsies, a rare manifestation of GCA.
• The clinical presentation included specific cranial nerve deficits impacting ocular motility.

Findings:

• The findings confirm GCA as the underlying cause of multiple cranial nerve palsies in these patients.
• Histopathological confirmation of arteritis was obtained through biopsy.
• The cases underscore the potential for GCA to present with atypical neurological deficits.

Implications:

• These cases suggest that multiple cranial nerve palsies should be considered in the differential diagnosis of GCA, even in the absence of typical symptoms.
• Early recognition and treatment of GCA are crucial to prevent irreversible vision loss and other neurological damage.
• Further research may elucidate the mechanisms behind multiple cranial nerve involvement in GCA.