Related Experiment Videos
Clivus and cervical spinal osteomyelitis with epidural abscess presenting with multiple cranial neuropathies
S A Azizi1, P B Fayad, R Fulbright
1Department of Neurology, Yale School of Medicine, New Haven, CT 06510, USA.
Clinical Neurology and Neurosurgery
|August 1, 1995
Summary
Clival osteomyelitis, a rare infection, can cause serious cranial nerve palsies and neurological deficits. Early recognition and antibiotic treatment are crucial for patient recovery and preventing complications.
Area of Science:
- Neurology
- Infectious Diseases
- Otolaryngology
Background:
- Clival osteomyelitis is a rare but serious infection affecting the skull base.
- It can present with diverse neurological symptoms due to its proximity to critical structures.
Observation:
- A 65-year-old diabetic patient with otitis history presented with headache, neck pain, and multiple cranial nerve palsies (CN VI, VII, XII), hearing loss, and ptosis.
- Cerebrospinal fluid (CSF) analysis showed elevated protein and pleocytosis.
- Imaging revealed clival osteomyelitis extending into the epidural and prevertebral spaces to the cervical spine.
Findings:
- Osteomyelitis of the clivus involving adjacent spaces.
- Cranial nerve palsies and neurological deficits secondary to infection spread.
- Successful treatment with antibiotics and cervical immobilization.
Implications:
- Highlights the importance of considering clival osteomyelitis in patients with unexplained cranial nerve abnormalities.
- Emphasizes the need for prompt diagnosis and management to prevent severe neurological sequelae.
- Underscores the role of advanced imaging in identifying skull base infections.