ANCA-negative wegener's granulomatosis with multiple lower cranial nerve palsies

Sung Hee Kim, Jin Park, Jung Ho Bae, Min Sun Cho, Kee Duk Park, Jee Hyang Jeong

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11 Scopus citations


Wegener's granulomatosis (WG) is a systemic vasculitis affecting small and medium-sized vessels with granulomatous formation. Though it is known for respiratory tract and kidney involvement, neurologic manifestation has been also reported. Herein we report a patient who suffered pansinusitis with multiple lower cranial nerve palsies but reached remission by immunosuppressant after the diagnosis of WG. A 54-yr-old female visited with headache, hearing difficulty, and progressive bulbar symptoms. She experienced endoscopic sinus surgeries due to refractory sinusitis. Neurologic examination revealed multiple lower cranial nerve palsies. Vasculitic markers showed no abnormality. Nasal biopsy revealed granulomatous inflammation and vasculitis involving small vessels. Given cyclophosphamide and prednisolone, her symptoms were prominently improved. WG should be considered in the patient with multiple cranial nerve palsies, especially those with paranasal sinus disease. Because WG can be lethal if delayed in treatment, prompt immunosuppressant is warranted after the diagnostic tissue biopsy.

Original languageEnglish
Pages (from-to)1690-1696
Number of pages7
JournalJournal of Korean Medical Science
Issue number11
StatePublished - 2013

Bibliographical note

Publisher Copyright:
© 2013 The Korean Academy of Medical Sciences.


  • Cranial nerve diseases
  • Refractory sinusitis
  • Wegener granulomatosis
  • c-ANCA negative


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