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Combined 6th and 12th Cranial Nerve Palsies (Godtfredsen Syndrome) due to Clival Lesions
Rhys T Ishihara1, Zhenyang Zhao, Sibi Rajendran
1Department of Ophthalmology (RI, ZZ, AS, ZD, AGL), University of Texas Medical Branch, Galveston, Texas; Department of Ophthalmology (RI, ZZ, SR, AS, ZD, DSB, AGL), Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas; The Houston Methodist Research Institute (AGL), Houston Methodist Hospital, Houston, Texas; Departments of Ophthalmology, Neurology, and Neurosurgery (AGL), Weill Cornell Medicine, New York, New York; University of Texas MD Anderson Cancer Center (AGL), Houston, Texas; Texas A and M College of Medicine (AT, AGL), Bryan, Texas; Department of Ophthalmology (AGL), The University of Iowa Hospitals and Clinics, Iowa City, Iowa; Baylor College of Medicine (AGL), Houston, Texas; Department of Neurosurgery (SR, DSB), Houston Methodist Neurological Institute, Houston, Texas; and Department of Neurosurgery (DSB), Kenneth R. Peak Brain and Pituitary Tumor Treatment Center, Houston, Texas.
Background:
Godtfredsen syndrome (GS), originally described by Dr. Erik Godtfredsen in 1946, is the combination of cranial nerve (CN) 6th and 12th palsies. The most common etiology of GS is a lesion of the clivus.
Methods:
A retrospective case series of GS is described.
Results:
Three patients were included: 1) a 38-year-old woman with a clival breast cancer metastasis; 2) a 35-year-old woman with a clival chordoma; and 3) a 72-year-old woman with a partially embolized dural arteriovenous fistula involving the hypoglossal canal.
Conclusions:
GS is a combination of CN 6th and 12th palsies and most commonly is due to a lesion in the clivus. Clinicians should be aware of this uncommon combination of cranial nerve findings, the localizing significance, and the differential diagnosis of clival lesions.
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