Recovery from Multiple Cranial Nerve Palsy of Wegener’s Granulomatosis with Infliximab

Excerpt

To the Editor:

Wegener’s granulomatosis (WG)-related intracranial involvement is classified into 3 forms: contiguous invasion of granuloma from extracranial sites, remote intracranial granuloma, and central nervous system vasculitis^1,2. We describe a case of WG in which the extension of granuloma from extracranial sites of the skull base resulted in refractory multiple cranial nerve palsy that was dramatically resolved by infliximab therapy.

A 42-year-old man had developed bilateral hearing loss and facial nerve palsy since November 2004. Pulmonary nodules were observed and partial resection of the left upper lobe was performed, with a pathological finding of necrotizing vasculitis with granulomatous formation…