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July 1, 1974

Unilateral Paralysis of Cranial Nerves X to XII

Author Affiliations

St. Mary's Hospital San Francisco

JAMA. 1974;229(1):24. doi:10.1001/jama.1974.03230390016009

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To the Editor.—  The recent letters by Mayer and Opran (227:326, 1974) and by Chusid (228:28, 1974) remind me of personal experiences with three patients who developed unilateral paralysis of cranial nerves X, XI, and XII.In the first patient, paralysis developed suddenly, coincident with a pharyngitis and severe cervical lymphadenitis on the side of the paralysis. The second patient had nasopharyngeal carcinoma, documented by biopsy, with metastases to the cervical lymph nodes on the side of the neurologic dysfunction. The third and most recent patient developed paralysis of cranial nerves X, XI, and XII on the left side following a right carotid endarterectomy.In the first case described, no abnormalities were detected on extensive investigation including pneumoencephalography; the neurologic deficit has remained fixed. The second patient is currently receiving radiation therapy, and his neurologic deficit is stable. In the third patient, intubation for her operation was difficult, and I suspect