Abstract
Objective: To assess the clinicopathological spectrum, patterns, and diagnostic significance of Cranial Nerve (CN) dysfunction in systemic vasculitides and inflammatory disorders.
Methodology: This cross-sectional, observational study included 50 patients with systemic vasculitis (SV) or other systemic inflammatory diseases, including Systemic Lupus Erythematosus (SLE), granulomatosis with polyangiitis (GPA), or rheumatoid arthritis (RA), who presented with CN deficits. MRI/CT, clinical examination, and laboratory tests, including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Anti-nuclear antibody (ANA), and anti-neutrophil cytoplasmic antibody (ANCA), were utilized. The laterality, frequency, disease association with severity, and the number of nerves involved were recorded. The data were analyzed through SPSS version 26.0. The chi-square test was used to test associations between CN involvement and disease variables, with a p<0.05 as a significant level.
Results: The mean age of the participants was 46.8±12.5 years, and 28 (56%) were males. Eighteen (36%) patients had SLE, and 14 (28%) had GPA. The most involved nerve was the facial nerve, CN VII, in 24 cases (48%), followed by the optic nerve, CN II, in 10 cases (20%), and the oculomotor nerve, CN III, in 7 cases (14%). MRI abnormalities were seen in 64% patients. ESR/CRP were elevated in 41(82%) patients, and 38 (76%) were positive for autoantibodies (ANA or ANCA). Bilateral involvement was present in 11(22%) patients.. Partial or complete recovery was observed in patients within three months after either corticosteroids or immunosuppressive therapy. Conclusion: The CN, particularly the facial and optic nerves, is an interesting neurological determinant in SV and inflammatory diseases. Serological markers and MRI are often abnormal in the affected individuals.

Key words: Cranial nerve palsy, systemic vasculitis, systemic lupus erythematosus, granulomatosis with polyangiitis, MRI, autoantibodies, inflammation.