{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:41:06Z","timestamp":1787071266997,"version":"build-2736575974"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","license":[{"start":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T00:00:00Z","timestamp":1773273600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To analyze skull base osteomyelitis as a cause of isolated and multiple cranial nerve palsies. Report presentations of otogenic and non-otogenic types. Emphasize the importance of neuroimaging with contrast at the first visit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Single-center retrospective observational study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>Institutional.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Population:<\/jats:title>\n                    <jats:p>A total of 276 patients with cranial nerve palsies over a period of four months. Of these, 20 patients with SBO were included in the study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Observation Procedure:<\/jats:title>\n                    <jats:p>Complete ocular examination and magnetic resonance imaging (MRI) of the brain and orbit with contrast for all patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measure:<\/jats:title>\n                    <jats:p>Radiological\/microbiological diagnosis of SBO.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Most of our patients were between 70 and 75 years. Time from the onset of symptoms to presentation was between one week and one month. A total of 75% had diabetes mellitus. A total of 90% had unilateral presentation. Most common presenting symptom was double vision and headache seen in 45%. A total of 70% had a non-otogenic source of infection. Sphenoid sinus was involved in 50%. MRI of brain and orbit with contrast showed sinusitis in 45% and otomastoiditis in 35%. Fungi were isolated on biopsy in 30%, bacteria in 15%, acid-fast bacilli in 5%. Intravenous antibiotics were given to 55% and intravenous antifungal was given to 25%. Transnasal sinus surgery was performed in 30%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Isolated cranial palsy does not exclude infectious etiology even if patient has comorbidities like uncontrolled diabetes, particularly if associated with headache and pain. Hence, neuroimaging with contrast is required.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijo.ijo_2852_24","type":"journal-article","created":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T16:02:04Z","timestamp":1773331324000},"page":"1191-1195","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Nerve-rattling infections! Clinical and radiological tracing of cranial nerve palsies to infectious skull base osteomyelitis"],"prefix":"10.4103","volume":"74","author":[{"given":"R","family":"Sharanya","sequence":"first","affiliation":[{"name":"Department of Neuroophthalmology, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Coimbatore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pankti","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Neuroophthalmology, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Coimbatore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karthik K","family":"Mani","sequence":"additional","affiliation":[{"name":"Department of Neuroophthalmology, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Coimbatore, Tamil Nadu, 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