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Isolated neurosarcoidosis presenting with multiple cranial nerve palsies

BACKGROUND: As an extremely rare subtype of sarcoidosis that develops exclusively in the nervous system, isolated neurosarcoidosis is difficult to diagnose. In addition, its exact clinical features are not known. CASE DESCRIPTION: A 61-year-old man presented with right ear hearing loss, diplopia, an...

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Autores principales: Shimizu, Kiyoharu, Yuki, Kiyoshi, Sadatomo, Takashi, Kurisu, Kaoru
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4854028/
https://www.ncbi.nlm.nih.gov/pubmed/27168947
http://dx.doi.org/10.4103/2152-7806.180765
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author Shimizu, Kiyoharu
Yuki, Kiyoshi
Sadatomo, Takashi
Kurisu, Kaoru
author_facet Shimizu, Kiyoharu
Yuki, Kiyoshi
Sadatomo, Takashi
Kurisu, Kaoru
author_sort Shimizu, Kiyoharu
collection PubMed
description BACKGROUND: As an extremely rare subtype of sarcoidosis that develops exclusively in the nervous system, isolated neurosarcoidosis is difficult to diagnose. In addition, its exact clinical features are not known. CASE DESCRIPTION: A 61-year-old man presented with right ear hearing loss, diplopia, and fever. Computed tomography (CT) and magnetic resonance imaging revealed mass lesions in the right cerebellum and left side body of the lateral ventricle. Neither systemic CT nor positron emission tomography revealed extracranial lesions. A neuroendoscopic biopsy was performed on the lateral ventricle lesion, and a histopathology analysis revealed epithelioid granulomatous inflammation. By systematic exclusion of other possible granulomatous diseases, isolated neurosarcoidosis was diagnosed. The lesions disappeared immediately upon corticosteroid (methylprednisolone) treatment and had not recurred as of a 12-month follow-up examination. CONCLUSIONS: Isolated neurosarcoidosis is difficult to diagnose. Successful diagnosis requires compatible clinical findings, histological demonstration of noncaseating granulomas, and exclusion of other granulomatous diseases. Isolated neurosarcoidosis has a relatively good clinical prognosis, which could be characteristic of the disease.
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spelling pubmed-48540282016-05-10 Isolated neurosarcoidosis presenting with multiple cranial nerve palsies Shimizu, Kiyoharu Yuki, Kiyoshi Sadatomo, Takashi Kurisu, Kaoru Surg Neurol Int Case Report BACKGROUND: As an extremely rare subtype of sarcoidosis that develops exclusively in the nervous system, isolated neurosarcoidosis is difficult to diagnose. In addition, its exact clinical features are not known. CASE DESCRIPTION: A 61-year-old man presented with right ear hearing loss, diplopia, and fever. Computed tomography (CT) and magnetic resonance imaging revealed mass lesions in the right cerebellum and left side body of the lateral ventricle. Neither systemic CT nor positron emission tomography revealed extracranial lesions. A neuroendoscopic biopsy was performed on the lateral ventricle lesion, and a histopathology analysis revealed epithelioid granulomatous inflammation. By systematic exclusion of other possible granulomatous diseases, isolated neurosarcoidosis was diagnosed. The lesions disappeared immediately upon corticosteroid (methylprednisolone) treatment and had not recurred as of a 12-month follow-up examination. CONCLUSIONS: Isolated neurosarcoidosis is difficult to diagnose. Successful diagnosis requires compatible clinical findings, histological demonstration of noncaseating granulomas, and exclusion of other granulomatous diseases. Isolated neurosarcoidosis has a relatively good clinical prognosis, which could be characteristic of the disease. Medknow Publications & Media Pvt Ltd 2016-04-19 /pmc/articles/PMC4854028/ /pubmed/27168947 http://dx.doi.org/10.4103/2152-7806.180765 Text en Copyright: © 2016 Surgical Neurology International http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Case Report
Shimizu, Kiyoharu
Yuki, Kiyoshi
Sadatomo, Takashi
Kurisu, Kaoru
Isolated neurosarcoidosis presenting with multiple cranial nerve palsies
title Isolated neurosarcoidosis presenting with multiple cranial nerve palsies
title_full Isolated neurosarcoidosis presenting with multiple cranial nerve palsies
title_fullStr Isolated neurosarcoidosis presenting with multiple cranial nerve palsies
title_full_unstemmed Isolated neurosarcoidosis presenting with multiple cranial nerve palsies
title_short Isolated neurosarcoidosis presenting with multiple cranial nerve palsies
title_sort isolated neurosarcoidosis presenting with multiple cranial nerve palsies
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4854028/
https://www.ncbi.nlm.nih.gov/pubmed/27168947
http://dx.doi.org/10.4103/2152-7806.180765
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