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Acute aspiration pneumonia due to bulbar palsy: an initial manifestation of posterior fossa convexity meningioma
  1. S N Shenoy,
  2. A Raja
  1. Department of Neurosurgery, Kasturba Medical College and Hospital, Manipal, India
  1. Correspondence to:
 Satyanarayana N Shenoy
 Department of Neurosurgery, Kasturba Medical College and Hospital, MANIPAL–576 119, UDUPI, Karnataka, India; shenoysnyahoo.com

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False localising signs of intracranial lesions are defined as signs not generally associated with disturbances of function at the site of the lesion.1,2 An intracranial tumour which has not metastasised may give rise to focal signs of disordered nervous function at a distance from itself in a number of ways. Even though these neurological signs are labelled as false localising signs, it is important to be aware that such signs are in no way “false”.3 Various cranial nerve palsies have been reported as false localising signs, with the sixth cranial nerve being the most common.1 According to Gassel, ninth to 12th cranial nerve palsies never provide false localisation.1 Since Dodge reported the first case of false localising sign involving the lower cranial nerve, only two cases have been reported in the literature.4 We report a third case of false localising sign involving the left ninth and 10th cranial nerves.

A 29 year old man presented to the medical department of our hospital with history of hoarseness of voice of 15 days duration, dysphagia of 1 week duration, and cough with expectoration and respiratory distress of 2 days duration together with history of fever. On examination, he was febrile, with a pulse of 100 bpm and blood pressure of 120/80 mm Hg. Respiratory examination revealed bilateral coarse crepitations. Neurological examination revealed absent gag reflex on the left side with deviation of the …

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  • Competing interests: none declared