Abstract:
INTRODUCTION:We present a case of a foramen magnum meningioma that highlights the importance of the neurologic exam when evaluating a patient with dysphagia. A 58-year-old woman presented with an 18-month history of progressive dysphagia, chronic cough and 30-pound weight loss. Prior gastroenterologic and laryngologic workup was unrevealing. RESULTS:Her neurologic examination revealed an absent gag reflex, decreased sensation to light touch on bilateral distal extremities, hyperreflexia, and tandem gait instability. Repeat esophagogastroduodenoscopy was normal, whereas laryngoscopy and video fluoroscopy revealed marked hypopharyngeal dysfunction. Brain magnetic resonance imaging demonstrated a 3.1 x 2.7 x 2.9 cm foramen magnum mass consistent with meningioma. The patient underwent neurosurgical resection of her mass with near complete resolution of her neurologic symptoms. Pathology confirmed diagnosis of a WHO grade I meningothelial meningioma. CONCLUSION:CNS pathology is an uncommon but impressive cause of dysphagia. Our case demonstrates the importance of a thorough neurologic survey when evaluating such a patient.
journal_name
J Gen Intern Medjournal_title
Journal of general internal medicineauthors
Tsao GJ,Tsang MW,Mobley BC,Cheng WWdoi
10.1007/s11606-007-0474-zsubject
Has Abstractpub_date
2008-02-01 00:00:00pages
206-9issue
2eissn
0884-8734issn
1525-1497journal_volume
23pub_type
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