Sixth cranial nerve palsy and ipsilateral segmental carotid arteritis after tooth alveolectomy

  • Biljana Dapic IvancicEmail author
  • Ivan Jovanovic
  • Josip Ljevak
  • Zdravka Poljakovic
Letter to the Editor

Dear editor,

Isolated sixth cranial nerve palsy caused by sphenoid sinusitis is a rare condition, especially if associated with segmental internal carotid arteritis (ICA). To our knowledge, there are 17 case reports describing sixth cranial nerve palsy secondary to sphenoid sinusitis and 18 case reports describing an isolated atypical arteritis of ICA. One of these reports presented novel “isolated internal carotid arteritis” disease concept which suggests arteritis caused by autoimmune disease of unknown cause is confirmed with the efficacy of steroid therapy and has no other symptoms or organ involvements, or autoantibodies (such as systemic lupus erythematosus and medium- or small-vessel vasculitis or Behçet’s disease) indicating autoimmune disease. Tuberculosis also has to be excluded, due to possible infectious vasculitis of sole ICA in tuberculous patient [1, 2, 3].

On the other hand, isolated sphenoid sinusitis (ISS) is a rare disease which accounts for 1% to 2% of all paranasal...


Compliance with ethical standards

Ethical approval

This article does not contain research including human participants or animals performed by any of the authors.

Informed consent

Informed consent was obtained from the patient included in the study.

Conflict of interest

The authors declare that they have no conflict of interest.


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    El Mograbi A, Soudry E (2017) Ocular cranial nerve palsies secondary to sphenoid sinusitis. World J Otorhinolaryngol Head Neck Surg 3(1):49–53. CrossRefGoogle Scholar
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    Fukuma K, Kowa H, Nakayasu H, Nakashima K (2016) Atypical arteritis in internal carotid arteries: a novel concept of isolated internal carotid. Yonago Acta Med. 59(3):248–254Google Scholar
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    Gupta R, Shukla R, Mishra A, Parihar A (2015) Isolated acute sphenoid sinusitis presenting with hemicranial headache and ipsilateral abducens nerve palsy. BMJ Case Rep 2015:bcr2015209408. CrossRefGoogle Scholar

Copyright information

© Fondazione Società Italiana di Neurologia 2019

Authors and Affiliations

  1. 1.Department of NeurologyGeneral Hospital ZadarZadarCroatia
  2. 2.Department of Diagnostic and Interventional RadiologyUniversity Hospital Centre Zagreb, School of Medicine, University of ZagrebZagrebCroatia
  3. 3.Department of Neurology, University Hospital Centre Zagreb, School of Medicine, Referral Centre of the Ministry of Health of the Republic of Croatia for Intensive Neurology and Endovascular Treatment of Stroke and Vascular Malformations of the Central Nervous SystemUniversity of ZagrebZagrebCroatia

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