Headache, chest pain, and multiplex cranial neuropathy

  • Giuseppe Lauria PinterEmail author
  • Franco Ferracci
  • Susanna Usai
  • Daniele Cazzato
  • Alessandra Erbetta
  • Alessandro Perin
  • Gianluca Marucci
Letter to the Editor

Case report

A 58-year-old man with unremarkable past medical history presented with severe episodic right-side periocular pain radiating to the frontal-temporal-parietal region, associated with unstable diplopia in the horizontal gaze. The clinical examination showed partial palsy of the right third cranial nerve sparing the intrinsic function. Prednisone 50 mg daily for 2 weeks was prescribed with sudden relief of pain and recovery of diplopia. Fifteen days after prednisone withdrawal, headache and diplopia caused by right sixth cranial nerve palsy reappeared. Intravenous methylprednisolone (1 g daily for 3 days) was given with transient full recovery. Two weeks later, the patient was readmitted due to recurrent severe headache and started prednisone 75 mg daily. Nevertheless, he developed diffuse chronic headache, bilateral sixth and partial left third cranial nerve palsy, right-side Claude-Bernand-Horner syndrome, dysphagia and dysphonia, intense chest pain, and gait unsteadiness...


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Fondazione Società Italiana di Neurologia 2019

Authors and Affiliations

  1. 1.Neuroalgology UnitFondazione IRCCS Istituto Neurologico Carlo BestaMilanItaly
  2. 2.Department of Biomedical, Clinical Sciences “Luigi Sacco”University of MilanMilanItaly
  3. 3.Department of NeurologySan Martino HospitalBellunoItaly
  4. 4.NeuroradiologyFondazione IRCCS Istituto Neurologico Carlo BestaMilanItaly
  5. 5.Oncological NeurosurgeryFondazione IRCCS Istituto Neurologico Carlo BestaMilanItaly
  6. 6.Neuropathology UnitFondazione IRCCS Istituto Neurologico Carlo BestaMilanItaly

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