Cargando…

Isolated Neurosarcoidosis Presenting as Chronic Progressive Pachymeningitis

Neurologic manifestations of sarcoidosis are rare, and even rarer still are cases of isolated neurosarcoidosis. The clinical presentation of isolated neurosarcoidosis can be highly variable, and diagnosis is particularly challenging, the gold standard being tissue biopsy. We describe a patient with...

Descripción completa

Detalles Bibliográficos
Autores principales: Abata, Joshua, Bazer, Danielle, Koroneos, Nicholas, Syritsyna, Olga
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10019966/
https://www.ncbi.nlm.nih.gov/pubmed/36936604
http://dx.doi.org/10.1155/2023/2140740
_version_ 1784908145735237632
author Abata, Joshua
Bazer, Danielle
Koroneos, Nicholas
Syritsyna, Olga
author_facet Abata, Joshua
Bazer, Danielle
Koroneos, Nicholas
Syritsyna, Olga
author_sort Abata, Joshua
collection PubMed
description Neurologic manifestations of sarcoidosis are rare, and even rarer still are cases of isolated neurosarcoidosis. The clinical presentation of isolated neurosarcoidosis can be highly variable, and diagnosis is particularly challenging, the gold standard being tissue biopsy. We describe a patient with a history of atypical parkinsonian syndrome and chronic right frontal lobe infarct who developed weakness, imbalance, and gait disequilibrium in 2008, with magnetic resonance imaging at that time showing leptomeningeal and nodular enhancements in the bilateral frontal and parietal lobes. The patient had an extensive negative workup in 2010 but ultimately did not receive a definitive diagnosis with a tissue biopsy until 2020. The patient also notably failed a 3-month course of steroids after his biopsy due to a lack of symptomatic improvement. This case highlights the clinical variability and diagnostic difficulties of isolated neurosarcoidosis. We also highlight that our patient did not have any symptomatic improvement on steroids, which do typically provide some relief for patients.
format Online
Article
Text
id pubmed-10019966
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Hindawi
record_format MEDLINE/PubMed
spelling pubmed-100199662023-03-17 Isolated Neurosarcoidosis Presenting as Chronic Progressive Pachymeningitis Abata, Joshua Bazer, Danielle Koroneos, Nicholas Syritsyna, Olga Case Rep Neurol Med Case Report Neurologic manifestations of sarcoidosis are rare, and even rarer still are cases of isolated neurosarcoidosis. The clinical presentation of isolated neurosarcoidosis can be highly variable, and diagnosis is particularly challenging, the gold standard being tissue biopsy. We describe a patient with a history of atypical parkinsonian syndrome and chronic right frontal lobe infarct who developed weakness, imbalance, and gait disequilibrium in 2008, with magnetic resonance imaging at that time showing leptomeningeal and nodular enhancements in the bilateral frontal and parietal lobes. The patient had an extensive negative workup in 2010 but ultimately did not receive a definitive diagnosis with a tissue biopsy until 2020. The patient also notably failed a 3-month course of steroids after his biopsy due to a lack of symptomatic improvement. This case highlights the clinical variability and diagnostic difficulties of isolated neurosarcoidosis. We also highlight that our patient did not have any symptomatic improvement on steroids, which do typically provide some relief for patients. Hindawi 2023-03-09 /pmc/articles/PMC10019966/ /pubmed/36936604 http://dx.doi.org/10.1155/2023/2140740 Text en Copyright © 2023 Joshua Abata et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Abata, Joshua
Bazer, Danielle
Koroneos, Nicholas
Syritsyna, Olga
Isolated Neurosarcoidosis Presenting as Chronic Progressive Pachymeningitis
title Isolated Neurosarcoidosis Presenting as Chronic Progressive Pachymeningitis
title_full Isolated Neurosarcoidosis Presenting as Chronic Progressive Pachymeningitis
title_fullStr Isolated Neurosarcoidosis Presenting as Chronic Progressive Pachymeningitis
title_full_unstemmed Isolated Neurosarcoidosis Presenting as Chronic Progressive Pachymeningitis
title_short Isolated Neurosarcoidosis Presenting as Chronic Progressive Pachymeningitis
title_sort isolated neurosarcoidosis presenting as chronic progressive pachymeningitis
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10019966/
https://www.ncbi.nlm.nih.gov/pubmed/36936604
http://dx.doi.org/10.1155/2023/2140740
work_keys_str_mv AT abatajoshua isolatedneurosarcoidosispresentingaschronicprogressivepachymeningitis
AT bazerdanielle isolatedneurosarcoidosispresentingaschronicprogressivepachymeningitis
AT koroneosnicholas isolatedneurosarcoidosispresentingaschronicprogressivepachymeningitis
AT syritsynaolga isolatedneurosarcoidosispresentingaschronicprogressivepachymeningitis