A case of Garcin's syndrome associated with carcinoma of the middle ear.

The unilateral involvement of all or nearly all of the cranial nerves, associated with various conditions, was first described by Garcin in 1926. Different conditions such as tumors or inflammations are known to be causes of this syndrome. The primary carcinoma of the middle ear is one of causes of the syndrome of Garcin. In Japan, we have had no report of this syndrome caused by the tumors of the middle ear. A 54-year-old right-handed male with this syndrome who began to complain of an occlusive feeling in the right ear in August, 1966 and ultimately developed nearly total unilateral involvement of the cranial nerves on the right side was written. There was no evidence of increased intracranial pressure, and the X-ray film of the basal v iew showed invasion of the tumor. Typical findings of Garcin's syndrome were emphasized in this report. The unilateral involvement of all or nearly all of the cranial nerves, associated with various conditions, was first decribed by Garcin in 1926 1' . He presented three criteria for the diagnosis of this rare syndrome. At the present time, the "syndrom paralytique unilateral global des nerfs craniens" is characterized by 1. unilateral involvement of all cranial nerves, 2. absence of any signs of involvement of motor or sensory systems m extrimities, 3. absence of any signs of increased intracranial pressure, 4. abnormal X-ray findings of the base of the skutf"2>> Many authors have described the following conditions as the cause of this synarome: nasopharyngeal tumor, sarcoma of the base of the skull or meninges, middle ear tumor, meningioma, neurinoma, chordoma, myoma, cholesteatoma, craniopharingioma, brain-stem glioma, lymphangioma and luetic or tuberculous meningitis 3' 10'. On the other hand, it is believed that the primary carcinoma of the middle ear is relatively rare 11' 12' 13' . It may cause various neurological syndrome, such as Gradenigo's syndrome, Vernet's syndrome and Schmidt's Syndrome 14' 15', however, Garcin's syndrome /liT !l!f ~ ;I( Received for publication December 23. 1969.