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Published in: Indian Journal of Hematology and Blood Transfusion 1/2016

01-06-2016 | Case Report

Bilateral Facial Nerve Palsy in Acute B Cell Lymphoblastic Leukemia: A Case Report and Review of the Literature

Authors: Shiraj Sen, Arjun Gupta, Paul Friedman, Harris V. Naina

Published in: Indian Journal of Hematology and Blood Transfusion | Special Issue 1/2016

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Abstract

Acute lymphoblastic leukemia (ALL) is a haematological malignancy that can involve the central nervous system (CNS). Less than 10 % of patients with ALL have CNS involvement at presentation. The cranial nerve most commonly affected is cranial nerve VII although bilateral involvement is rare. Management and outcomes of these patients are not well understood. Moreover bilateral Bells palsy as a presenting symptom of ALL is extremely uncommon. We report a very unusual presentation of ALL with bilateral facial nerve palsy, and discuss the management strategies and outcomes for patients with ALL that present with cranial nerve palsies.
Literature
1.
go back to reference Kantarjian H, O’Brien S, Smith T et al (2000) Results of treatment with hyper-CVAD, a dose intensive regimen, in adult acute lymphocytic leukemia. J Clin Oncol 1(18):547–561 Kantarjian H, O’Brien S, Smith T et al (2000) Results of treatment with hyper-CVAD, a dose intensive regimen, in adult acute lymphocytic leukemia. J Clin Oncol 1(18):547–561
2.
go back to reference Rowe J, Buck G, Burnett A et al (2005) Induction therapy for adults with acute lymphoblastic leukemia: results of more than 1500 patients from the international ALL trial: MRC UKALL XII/ECOG E2993. Blood 106(12):3760–3767CrossRefPubMed Rowe J, Buck G, Burnett A et al (2005) Induction therapy for adults with acute lymphoblastic leukemia: results of more than 1500 patients from the international ALL trial: MRC UKALL XII/ECOG E2993. Blood 106(12):3760–3767CrossRefPubMed
3.
go back to reference Lazarus HM, Richards SM, Chopra R et al (2006) Central nervous system involvement in adult acute lymphoblastic leukemia at diagnosis: results from the international ALL trial MRC UKALL XII/ECOG E2993. Blood 108(2):465–472CrossRefPubMedPubMedCentral Lazarus HM, Richards SM, Chopra R et al (2006) Central nervous system involvement in adult acute lymphoblastic leukemia at diagnosis: results from the international ALL trial MRC UKALL XII/ECOG E2993. Blood 108(2):465–472CrossRefPubMedPubMedCentral
4.
go back to reference Peitersen E (2002) Bell’s palsy: the spontaneous course of 2,500 peripheral facial nerve palsies of different etiologies. Acta Otolaryngol 549:4–30CrossRef Peitersen E (2002) Bell’s palsy: the spontaneous course of 2,500 peripheral facial nerve palsies of different etiologies. Acta Otolaryngol 549:4–30CrossRef
5.
go back to reference Michaelis E, Rupprecht L, Mortier W (1974) Primary neurologic symptoms in diffuse lymphoreticular neoplasias. Monatsschr Kinderheilkd. 122(7):433–434PubMed Michaelis E, Rupprecht L, Mortier W (1974) Primary neurologic symptoms in diffuse lymphoreticular neoplasias. Monatsschr Kinderheilkd. 122(7):433–434PubMed
6.
go back to reference Garvey P, Lawrence J (1933) Facial diplegia in lymphatic leukaemia. JAMA 101(25):194CrossRef Garvey P, Lawrence J (1933) Facial diplegia in lymphatic leukaemia. JAMA 101(25):194CrossRef
7.
go back to reference Van Rossum J, Zwaan F, Bots G (1979) Facial palsy as the initial symptom of a lymphoreticular malignancy. Eur Neurol 18(3):212–216CrossRefPubMed Van Rossum J, Zwaan F, Bots G (1979) Facial palsy as the initial symptom of a lymphoreticular malignancy. Eur Neurol 18(3):212–216CrossRefPubMed
8.
go back to reference Kurabayashi H, Miyawaki S, Naruse T et al (1989) Bilateral tympanic cavity infiltration with effusion in a patient with acute myeloblastic leukemia. Blut 58(1):45–46CrossRefPubMed Kurabayashi H, Miyawaki S, Naruse T et al (1989) Bilateral tympanic cavity infiltration with effusion in a patient with acute myeloblastic leukemia. Blut 58(1):45–46CrossRefPubMed
9.
go back to reference Almadori G, Del Ninno M, Cadoni G et al (1996) Facial nerve paralysis in acute otomastoiditis as presenting symptom of FAB M2, T8;21 leukemic relapse. Case report and review of the literature. Int J Pediatr Otorhinolaryngol 36(1):45–52CrossRefPubMed Almadori G, Del Ninno M, Cadoni G et al (1996) Facial nerve paralysis in acute otomastoiditis as presenting symptom of FAB M2, T8;21 leukemic relapse. Case report and review of the literature. Int J Pediatr Otorhinolaryngol 36(1):45–52CrossRefPubMed
10.
go back to reference Grose C, Herle W, Henle G et al (1975) Primary Epstein–Barr-virus infections in acute neurologic diseases. N Engl J Med 292(8):392–395CrossRefPubMed Grose C, Herle W, Henle G et al (1975) Primary Epstein–Barr-virus infections in acute neurologic diseases. N Engl J Med 292(8):392–395CrossRefPubMed
11.
go back to reference Gallo R (1982) Regulation of human T-ceil proliferation: T-cell growth factor T-ceil leukaemia and lymphomas and isolation of a new c-type retrovirus. In: Rosenberg, Kapler (eds) Malignant lymphomas. Academic Press, New York, p 201 Gallo R (1982) Regulation of human T-ceil proliferation: T-cell growth factor T-ceil leukaemia and lymphomas and isolation of a new c-type retrovirus. In: Rosenberg, Kapler (eds) Malignant lymphomas. Academic Press, New York, p 201
13.
go back to reference Leibel S, Philips T (1998) Textbook of radiation oncology. WB Saunders, Philadelphia Leibel S, Philips T (1998) Textbook of radiation oncology. WB Saunders, Philadelphia
14.
go back to reference Gray JR, Wallner KE (1990) Reversal of cranial nerve dysfunction with radiation therapy in adults with lymphoma and leukemia. Int J Radiat Oncol Biol Phys 19:439–444CrossRefPubMed Gray JR, Wallner KE (1990) Reversal of cranial nerve dysfunction with radiation therapy in adults with lymphoma and leukemia. Int J Radiat Oncol Biol Phys 19:439–444CrossRefPubMed
15.
go back to reference Ha CS, Chung WK, Koller CA et al (1999) Role of radiation therapy to the brain in leukemic patients with cranial nerve palsies in the absence of radiological findings. Leuk Lymphoma 32:497–503CrossRefPubMed Ha CS, Chung WK, Koller CA et al (1999) Role of radiation therapy to the brain in leukemic patients with cranial nerve palsies in the absence of radiological findings. Leuk Lymphoma 32:497–503CrossRefPubMed
16.
go back to reference Ingram LC, Fairclough DL, Furman WL et al (1991) Cranial nerve palsy in childhood acute lymphoblastic leukemia and non-Hodgkin’s lymphoma. Cancer 67:2262–2268CrossRefPubMed Ingram LC, Fairclough DL, Furman WL et al (1991) Cranial nerve palsy in childhood acute lymphoblastic leukemia and non-Hodgkin’s lymphoma. Cancer 67:2262–2268CrossRefPubMed
17.
go back to reference Buykavci M et al (2002) An alarming sign for serious disease in children: bilateral facial paralysis. Pediatr Neurol 27:312–313CrossRef Buykavci M et al (2002) An alarming sign for serious disease in children: bilateral facial paralysis. Pediatr Neurol 27:312–313CrossRef
18.
go back to reference Ozcakar L, Akinci A, Özgöçmen S et al (2003) Bell’s palsy as an early manifestation of acute lymphoblastic leukemia. Ann Hematol 82:124–126PubMed Ozcakar L, Akinci A, Özgöçmen S et al (2003) Bell’s palsy as an early manifestation of acute lymphoblastic leukemia. Ann Hematol 82:124–126PubMed
19.
20.
go back to reference Averbach-Heller L, Gills S, Ben-Hur T (1994) Transient sixth-nerve palsy as the first presentation of acute leukemia. J Neurol Neurosurg Psychiatry 57:506CrossRef Averbach-Heller L, Gills S, Ben-Hur T (1994) Transient sixth-nerve palsy as the first presentation of acute leukemia. J Neurol Neurosurg Psychiatry 57:506CrossRef
21.
go back to reference de Fatima Soares M, Braga FT, da Rocha AJ et al (2005) Optic nerve infiltration by acute lymphoblastic leukemia: MRI contribution. Pediatr Radiol 37:799–802 de Fatima Soares M, Braga FT, da Rocha AJ et al (2005) Optic nerve infiltration by acute lymphoblastic leukemia: MRI contribution. Pediatr Radiol 37:799–802
22.
go back to reference Hsu WH, Chu SJ, Tsai WC et al (2008) Acute myeloid leukemia presenting as one-and-a-half syndrome. Am J Emerg Med 26:513.e1–513.e2 Hsu WH, Chu SJ, Tsai WC et al (2008) Acute myeloid leukemia presenting as one-and-a-half syndrome. Am J Emerg Med 26:513.e1–513.e2
23.
go back to reference Kulkarni KP, Marwaha RK, Trehan A et al (2009) Isolated right anterior chamber relapse in a patient of acute lymphoblastic leukemia presenting with facial nerve palsy. J Pediatr Hematol Oncol 31:990–991CrossRefPubMed Kulkarni KP, Marwaha RK, Trehan A et al (2009) Isolated right anterior chamber relapse in a patient of acute lymphoblastic leukemia presenting with facial nerve palsy. J Pediatr Hematol Oncol 31:990–991CrossRefPubMed
24.
go back to reference Tageja N, Valent J, Bentley G et al (2010) Precursor T cell acute lymphoblastic lymphoma presenting as bilateral facial nerve palsy. Chemotherapy 56:258–260CrossRefPubMed Tageja N, Valent J, Bentley G et al (2010) Precursor T cell acute lymphoblastic lymphoma presenting as bilateral facial nerve palsy. Chemotherapy 56:258–260CrossRefPubMed
25.
go back to reference Sasaki M, Yamazaki H, Aoki T et al (2011) Bilateral numb chin syndrome leading to a diagnosis of Burkitt’s cell acute lymphocytic leukemia: a case report and literature review. Oral Surg Med Oral Pathol Oral Radiol Endod 111:e11–e16CrossRef Sasaki M, Yamazaki H, Aoki T et al (2011) Bilateral numb chin syndrome leading to a diagnosis of Burkitt’s cell acute lymphocytic leukemia: a case report and literature review. Oral Surg Med Oral Pathol Oral Radiol Endod 111:e11–e16CrossRef
26.
go back to reference Young J, Susumu I (1996) Facial nerve palsy as an early manifestation of relapse in T-cell acute lymphoblastic leukemia. Ear Nose Throat J 75:157 Young J, Susumu I (1996) Facial nerve palsy as an early manifestation of relapse in T-cell acute lymphoblastic leukemia. Ear Nose Throat J 75:157
27.
go back to reference Ferrari J, Lang W, Thurnher S et al (2004) Bilateral facial nerve palsy as first indication of relapsing hairy cell leukemia after 36 years. Neurology 63:399–400CrossRefPubMed Ferrari J, Lang W, Thurnher S et al (2004) Bilateral facial nerve palsy as first indication of relapsing hairy cell leukemia after 36 years. Neurology 63:399–400CrossRefPubMed
28.
go back to reference Zappia J, Bunge F, Koopmann C et al (1990) Facial nerve paresis as the presenting symptom of leukemia. Int J Pediatr Otorhinolaryngol 19:259–264CrossRefPubMed Zappia J, Bunge F, Koopmann C et al (1990) Facial nerve paresis as the presenting symptom of leukemia. Int J Pediatr Otorhinolaryngol 19:259–264CrossRefPubMed
29.
go back to reference Sood B, Sharma B, Sharma A et al (2003) Facial palsy as first presentation of acute myeloid leukemia. Am J Hematol 74:200–201CrossRefPubMed Sood B, Sharma B, Sharma A et al (2003) Facial palsy as first presentation of acute myeloid leukemia. Am J Hematol 74:200–201CrossRefPubMed
30.
go back to reference Bilavsky, Scheuerman O, Garty B et al (2006) Facial paralysis as a presenting symptom of leukemia. Pediatr Neurol 34:502–504CrossRefPubMed Bilavsky, Scheuerman O, Garty B et al (2006) Facial paralysis as a presenting symptom of leukemia. Pediatr Neurol 34:502–504CrossRefPubMed
31.
go back to reference Karadag D, Karagulle A, Erden A et al (2002) Trigeminal nerve involvement in T-cell acute lymphoblastic leukemia: value of MR imaging. Eur J Radiol 44:16–18CrossRefPubMed Karadag D, Karagulle A, Erden A et al (2002) Trigeminal nerve involvement in T-cell acute lymphoblastic leukemia: value of MR imaging. Eur J Radiol 44:16–18CrossRefPubMed
32.
go back to reference Marwaha R, Kulkarni K, Trehan A et al (2010) Central nervous system involvement at presentation in childhood acute lymphoblastic leukemia: management experience and lessons. Leuk Lymphoma 51:261–268CrossRefPubMed Marwaha R, Kulkarni K, Trehan A et al (2010) Central nervous system involvement at presentation in childhood acute lymphoblastic leukemia: management experience and lessons. Leuk Lymphoma 51:261–268CrossRefPubMed
Metadata
Title
Bilateral Facial Nerve Palsy in Acute B Cell Lymphoblastic Leukemia: A Case Report and Review of the Literature
Authors
Shiraj Sen
Arjun Gupta
Paul Friedman
Harris V. Naina
Publication date
01-06-2016
Publisher
Springer India
Published in
Indian Journal of Hematology and Blood Transfusion / Issue Special Issue 1/2016
Print ISSN: 0971-4502
Electronic ISSN: 0974-0449
DOI
https://doi.org/10.1007/s12288-015-0526-1

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