A case of idiopathic soft palate paralysis with MRI contrast enhancement on the lower cranial nerves

Abstract

A boy aged 12 years consulted a local doctor due to rhinolalia aperta and dysphagia and was found to exhibit paralysis of the right soft palate. A head MRI scan revealed the possibility of an intracranial tumor, and he was referred to our department on day 14 after the onset of symptoms. The symptoms had resolved by day 8, and at the time of examination by our department, the rhinolalia aperta and dysphagia had disappeared. Although the head MRI FLAIR images displayed signs of a tumor-like artifact in the right ventral medulla, it was not visible in the sagittal view and was thus determined to be an artifact. Contrast-enhanced MRI revealed swelling of right cranial nerves IX and X, which were enhanced. Since no antecedent infection and rapid improvement in neurological symptoms was observed, a diagnosis of idiopathic soft palate paralysis was made.