Post-Craniopharyngioma and Cranial Nerve-VI Palsy Update on a MS Patient with Major Depression and Concurrent Neuroimmune Conditions

Navzer D Sachinvala; Angeline Stergiou; Duane E Haines; Armen Kocharian; Andrew Lawton

doi:10.3390/brainsci9100281

Post-Craniopharyngioma and Cranial Nerve-VI Palsy Update on a MS Patient with Major Depression and Concurrent Neuroimmune Conditions

Brain Sci. 2019 Oct 17;9(10):281. doi: 10.3390/brainsci9100281.

Authors

Navzer D Sachinvala¹, Angeline Stergiou², Duane E Haines^{3

4

5}, Armen Kocharian⁶, Andrew Lawton⁷

Affiliations

¹ United States Department of Agriculture, Agricultural Research Service, USDA-ARS, New Orleans, Home 2261 Brighton Place, Harvey, LA 70058, USA. Sachinvala@aol.com.
² Department of Medicine, Fairfield Medical Center, 401 North Ewing, Lancaster, OH 43130, USA. drangelinestergiou@gmail.com.
³ Department of Neurobiology and Anatomy, Wake Forest School of Medicine, 1 Medical Center Boulevard, Winston-Salem, NC 27157, USA. dhaines@wakehealth.edu.
⁴ Department of Neurology, Wake Forest School of Medicine, 1 Medical Center Boulevard, Winston-Salem, NC 27157, USA. dhaines@wakehealth.edu.
⁵ Department of Neurobiology and Anatomy, The University of Mississippi Medical Center, Jackson, MS 39216, USA. dhaines@wakehealth.edu.
⁶ Department of Radiology, Houston Methodist Hospital, 6565 Fannin Street, Houston, TX 77030, USA. akocharian@houstonmethodist.org.
⁷ Department of Ophthalmology, Ochsner Hospital, 1514 Jefferson Highway, New Orleans, 70121, USA. andrew.lawton@ochsner.org.

Abstract

We report the case of a male multiple sclerosis (MS) patient with type 2 diabetes (T2D), asthma, major depression (MD or major depressive disorder, MDD), and other chronic conditions, after his recent difficulties with craniopharyngioma and cranial nerve-VI (CN6) palsy. In addition, we show magnetic resonance image and spectroscopy (MRI, MRS), Humphrey's Visual Field (HVF), and retinal nerve fiber layer thickness (RNFLT) findings to explain the changes in the patient's health, and discuss the methods that helped/help him sustain productivity and euthymia despite long-standing problems and new CNS changes.

Keywords: S-adenosylmethionine; bupropion; cranial nerve-VI palsy; craniopharyngioma; fractionated stereotactic radiation treatments; major depression; multiple sclerosis; sphenoid sinusitis; vitamin D3; yoga.

Publication types

Case Reports