Vol.99 No.9 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 99 No. 9 September 2006
Relapse of Acute Lymphocytic Leukemia with
Involvement of the Posterior Cranial Fossa
Presenting with Vertigo and Facial Palsy
Akiko Adachi, Atushi Miyamoto, Akiko Yukimasa,
Michiko Node and Masafumi Sakagami
(Hyogo College Of Medicine)
Toru Seo
(Takarazuka Municipal Hospital)
A 15-year-old male complained of vertigo and was brought to our clinic on April 3, 2002. He showed rightward nystagmus with right fixation and rightward spontaneous nystagmus. Caloric test showed canal paresis of the left ear. Although there was a past history of acute lymphocytic leukemiam, he was in complete remission. Therefore, he was diagnosed as having vestibular neuritis of the left ear and treated with prednisolone. Balance problem improved for one week. However, he complained of recurrent dizziness on April 26, and left facial palsy on April 30. MRI showed enhancement in the posterior cranial fossa and cranial nerve (III, V, VI, VII, VIII, X nerve). He was diagnosed as having having relapsing leukemia with involvement of the central nervous system, and treated with intraspinal administration of methotrexate (MTX). Thereafter, dizziness and facial palsy were improved. In this case, lesion of the cranial nerve demonstrated on MRI differed from neurological symptoms. When patient having a past history of leukemia complain of vertigo, we must suspect relapse of leukemia, even if he/she was in complete remission.
Key words : acute lymphocytic leukemia, posterior cranial fossa, vertigo, facial palsy