Transient Central Facial Palsy at High Altitude: A Case Report.
Fiche publication
Date publication
juin 2021
Journal
High altitude medicine & biology
Auteurs
Membres identifiés du Cancéropôle Est :
Pr CHENUEL Bruno, Pr POUSSEL Mathias
Tous les auteurs :
Allado E, Chenuel B, Vauthier JC, Hily O, Richard S, Poussel M
Lien Pubmed
Résumé
Allado, Edem, Bruno Chenuel, Jean-Charles Vauthier, Oriane Hily, Sébastien Richard, and Mathias Poussel. Transient central facial palsy at high altitude: a case report. 00:000-000, 2020.-High altitude cerebral edema (HACE) is a severe form of acute mountain sickness (AMS). Besides this life-threatening condition, other neurological disorders may develop at high altitude, even if the precise pathophysiological mechanisms generally remain undetermined and are often debated. We report the case of a 34-year-old woman presenting with moderate AMS during an ascent of Mount Kilimanjaro. While descending from the summit, she suddenly experienced focal neurological symptoms of visual blurring, tinnitus, lightheadedness, and the findings of left-sided central facial palsy (flattened nasolabial fold, fall of labial commissure, dysarthria, difficulty in whistling, and facial dysesthesia). These symptoms and signs were confirmed in the field by a physician. Her symptoms regressed spontaneously and completely while continuing to descend. The etiology of this neurological episode at high altitude is discussed. The most probable diagnosis is a transient ischemic attack based on personal and familial vascular history, confirmed unilateral transient central facial palsy and normal results on standard blood work and cerebral magnetic resonance imaging. In this case, migraine should also be considered based on association of headache and transient focal neurological impairment. Overall, special attention should be given to mountaineers presenting with neurological conditions at altitude. Not only HACE should be considered but also the wide spectrum of other neurological conditions that fall outside the usual definition of altitude sickness.
Mots clés
altitude, facial paralysis, stroke
Référence
High Alt Med Biol. 2021 Jun 29;: