Goodman Brent P, Schrader Sara L
Department of Neurology, Mayo Clinic, Scottsdale, Arizona 85259, USA.
Neurologist. 2009 Mar;15(2):102-4. doi: 10.1097/NRL.0b013e31817ba3a6.
Baroreflex failure and bulbar palsy have been rarely reported as potential complications of radiotherapy for head and neck tumors. However, the occurrence of both disorders in the same patient has not been well described. We present a unique patient with radiation-induced cranial neuropathies, resulting in bulbar palsy and baroreflex failure.
A 67-year-old man underwent surgical resection of tonsillar squamous cell carcinoma and postoperative radiation therapy. Six years later, he developed severe orthostatic hypotension with syncope, followed later by progressive bulbar impairment. EMG showed myokymic discharges in the tongue, and marked orthostatic hypotension was noted on tilt-table testing.
Progressive bulbar impairment and baroreflex failure can occur following radiotherapy for head and neck cancers. Furthermore, these manifestations of radiation injury can occur in the same patient.
压力感受器反射衰竭和延髓麻痹作为头颈部肿瘤放疗的潜在并发症鲜有报道。然而，同一患者同时出现这两种病症的情况尚未得到充分描述。我们报告了一名因放疗导致颅神经病变，进而引发延髓麻痹和压力感受器反射衰竭的独特患者。
一名67岁男性接受了扁桃体鳞状细胞癌手术切除及术后放疗。六年后，他出现严重的体位性低血压并伴有晕厥，随后逐渐出现延髓功能障碍。肌电图显示舌部有肌束震颤放电，倾斜试验时出现明显的体位性低血压。
头颈部癌症放疗后可出现进行性延髓功能障碍和压力感受器反射衰竭。此外，这些放射损伤表现可出现在同一患者身上。
