[en] Occipital condylar fractures (OCFs) causing delayed onset lower cranial nerve paralysis (LCNPs) are rare. We present a 7-year-old Friesian horse with delayed onset dysphagia caused by vagus nerve (CNX) paralysis and suspicion of glossopharyngeal nerve (CNIX) paralysis developed several days after a minor head injury. Endoscopic examination revealed right laryngeal hemiplegia and intermittent dorsal displacement of the soft palate. An area of submucosal hemorrhage and bulging was appreciated over the dorsal aspect of the medial compartment of the right guttural pouch. Radiological examination of the proximal cervical region showed rotation of the atlas and the presence of a large bone fragment dorsal to the guttural pouches. Occipital condyle fracture with delayed onset cranial nerve paralysis was diagnosed. Delayed onset cranial nerve paralysis causing dysphagia might be a distinguishable sign of OCF in horses. Delayed onset dysphagia after head injury should prompt equine clinicians to evaluate the condition of the atlanto-occipital articulation and skull base.
Disciplines :
Veterinary medicine & animal health
Author, co-author :
Martin-Giménez, Tamara ; Veterinary Teaching Hospital, Faculty of Veterinary Sciences, Universidad Cardenal Herrera CEU, CEU Universities, Valencia, Spain
Cruz, Antonio M; Veterinary Teaching Hospital, Faculty of Veterinary Sciences, Universidad Cardenal Herrera CEU, CEU Universities, Valencia, Spain ; Department of Animal Medicine and Surgery, Faculty of Veterinary Sciences, Universidad Cardenal Herrera CEU, CEU Universities, Valencia, Spain
Barragán, Agustín; Pathological Anatomy Service. Faculty of Veterinary Sciences, Universidad Cardenal Herrera CEU, CEU Universities, Valencia, Spain
Montero, Estefanía; Pathological Anatomy Service. Faculty of Veterinary Sciences, Universidad Cardenal Herrera CEU, CEU Universities, Valencia, Spain
Sanchez, Pedro G; Veterinary Teaching Hospital, Faculty of Veterinary Sciences, Universidad Cardenal Herrera CEU, CEU Universities, Valencia, Spain
Caballero Delgado, Guillermo ; Veterinary Teaching Hospital, Faculty of Veterinary Sciences, Universidad Cardenal Herrera CEU, CEU Universities, Valencia, Spain
Corradini, Ignacio ; Veterinary Teaching Hospital, Faculty of Veterinary Sciences, Universidad Cardenal Herrera CEU, CEU Universities, Valencia, Spain ; Department of Animal Medicine and Surgery, Faculty of Veterinary Sciences, Universidad Cardenal Herrera CEU, CEU Universities, Valencia, Spain
Language :
English
Title :
Delayed onset vagus nerve paralysis after occipital condyle fracture in a horse.
Ramirez O, Jorgensen JS, Thrall DE. Imaging basilar skull fractures in the horse: a review. Vet Radiol Ultrasound. 1998;39:391-395.
Feary DJ, Magdesian KG, Aleman MA, Rhodes DM. Traumatic brain injury in horses: 34 cases (1994–2004). J Am Vet Med Assoc. 2007;231:259-266.
Lischer CJ, Walliser U, Witzmann P, Eser MW, Ohlerth S. Fracture of the paracondylar process in four horses: advantages of CT imaging. Equine Vet J. 2005;37:483-487.
Huang D-W, Tai S-H, Hung Y-C, Fang V-K, Lee M-Y, Lee E-J. A rare occipital condyle fracture in a patient with a minor head injury. Kaohsiung J Med Sci. 2009;25:342-346.
Karam YR, Traynelis VC. Occipital condyle fractures. Neurosurgery. 2010;66:56-59.
Theodore N, Aarabi B, Dhall SS, et al. Occipital condyle fractures. Neurosurgery. 2013;72:106-113.
Legros B, Fournier P, Chiaroni P, Ritz O, Fusciardi J. Basal fracture of the skull and lower (IX, X, XI, XII) cranial nerves palsy: four case reports including two fractures of the occipital condyle—a literature review. J Trauma Acute Care Surg. 2000;48:342.
Vadivelu S, Masood Z, Krueger B, et al. Long-term resolution of delayed onset hypoglossal nerve palsy following occipital condyle fracture: case report and review of the literature. J Craniovertebral Junction Spine. 2017;8:149-152.
Ducharme N. Grade system for equine laryngeal function. In: Dixon PM, Robinson E, Wade JF, eds. Proceedings of a Workshop on Equine Recurrent Laryngeal Neuropathy. Havemeyer Foundation Monograph Series No. 11. Newmarket, UK: R & W Publications; 2003:93-97.
Savi FM, Brierly GI, Baldwin J, Theodoropoulos C, Woodruff MA. Comparison of different decalcification methods using rat mandibles as a model. J Histochem Cytochem. 2017;65:705-722.
Voigt A, Saulez MN, Donnellan CM. Nuchal crest avulsion fracture in 2 horses: a cause of headshaking: clinical communication. J S Afr Vet Assoc. 2009;80:111-113.
Sweeney CR, Freeman DE, Sweeney RW, Rubin JL, Maxson AD. Hemorrhage into the guttural pouch (auditory tube diverticulum) associated with rupture of the longus capitis muscle in three horses. J Am Vet Med Assoc. 1993;202:1129-1131.
Tyler CM, Davis RE, Begg AP, Hutchins DR, Hodgson DR. A survey of neurological diseases in horses. Aust Vet J. 1993;70:445-449.
Bozkurt G, Hazer B, Yaman ME, Akbay A, Akalan N. Isolated paralysis of glossopharyngeal and vagus nerve associated with type II occipital condyle fracture: case report. Childs Nerv Syst. 2010;26:719-722.
Finsterer J, Grisold W. Disorders of the lower cranial nerves. J Neurosci Rural Pract. 2015;6:377-391.
Chen CT, Liu ZH, Lee ST, Tu PH. Delayed unilateral vocal cord paralysis caused by minor head trauma. Formos J Surg. 2016;49:230-232.
Erman AB, Kejner AE, Hogikyan ND, Feldman EL. Disorders of cranial nerves IX and X. Seminars in Neurology. Stuttgart, Germany: Thieme Medical Publishers; 2009:85.
De Lahunta A, Glass EN, Kent M. Veterinary Neuroanatomy and Clinical Neurology-E-Book. St. Louis, Mo: Elsevier Health Sciences; 2014.
Budras K-D, Sack WO, Rock S. Anatomy of the Horse: An Illustrated Text. Hannover, Germany: Schlütersche GmbH & Co.; 2003.
Nakagawa Y, Toda M, Shibao S, Yoshida K. Delayed and isolated oculomotor nerve palsy following minor head trauma. Surg Neurol Int. 2017;8:20.
Goyal RK, Chaudhury A. Physiology of normal esophageal motility. J Clin Gastroenterol. 2008;42:610-619.
Gutierrez LV, Kocak N, Cox AG. Alimentary transit and supersensitivity after vagotomy in the rat. Gut. 1971;12:625-628.
Tobi M, Holtz T, Carethers J, Owyang C. Delayed gastric emptying after laparoscopic anterior highly selective and posterior truncal vagotomy. Am J Gastroenterol. 1995;90:810-811.
Yoo SD, Kim DH, Lee SA, Joo HI, Yeo JA, Chung SJ. Bilateral cranial IX and X nerve palsies after mild traumatic brain injury. Ann Rehabil Med. 2016;40:168-171.
Lehn AC, Lettieri J, Grimley R. A case of bilateral lower cranial nerve palsies after base of skull trauma with complex management issues: case report and review of the literature. Neurologist. 2012;18:152-154.
