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Neurosarcoidosis

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https://www.readbyqxmd.com/read/29777892/surgically-treated-de-novo-cervico-medullary-arachnoid-cyst-in-a-symptomatic-adult-patient
#1
William Clifton, Gazanfar Rahmathulla, Kourosh Tavanaiepour, Dunbar Alcindor, George Jakubek, Daryoush Tavanaiepour
Arachnoid cysts are a relatively common finding in adult patients, especially with the advent of advanced imaging techniques. The overall incidence ranges from 1-2%, and the majority are clinically silent1,2 . Arachnoid cysts are postulated to arise by congenital anomalies or trauma1 . De novo formation of arachnoid cysts has been reported, but is exceptionally rare and mostly found in the pediatric population after head trauma3-5 . There have only been two reported cases of symptomatic de novo arachnoid cyst formation in adult patients to date, both with histories of head trauma6,7 ...
May 16, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29770929/two-cases-of-sarcoidosis-presenting-as-longitudinally-extensive-transverse-myelitis
#2
REVIEW
Amanda Mary Scott, Janeth Yinh, Timothy McAlindon, Robert Kalish
Neurosarcoidosis is uncommon with an incidence of approximately 5 to 15%. Central nervous system involvement can be divided into brain and spinal cord neurosarcoidosis. Spinal cord sarcoidosis is extremely rare, occurring in less than 1% of all sarcoidosis cases. Its manifestations may include cauda equina syndrome, radiculopathy, syringomyelia, cord atrophy, arachnoiditis, and myelopathy or transverse myelitis. We highlight two cases of spinal cord sarcoidosis, each presenting with longitudinally extensive transverse myelitis, that demonstrate the dilemmas that physicians face with regard to diagnosis and treatment...
May 17, 2018: Clinical Rheumatology
https://www.readbyqxmd.com/read/29737455/current-and-future-use-of-chloroquine-and-hydroxychloroquine-in-infectious-immune-neoplastic-and-neurological-diseases-a-mini-review
#3
REVIEW
Domenico Plantone, Tatiana Koudriavtseva
The process of finding new therapeutic indications for currently used drugs, defined as 'repurposing', is receiving growing attention. Chloroquine and hydroxychloroquine, with an original indication to prevent or cure malaria, have been successfully used to treat several infectious (HIV, Q fever, Whipple's disease, fungal infections), rheumatological (systemic lupus erythematosus, antiphospholipid antibody syndrome, rheumatoid arthritis, Sjögren's syndrome), and other immunological diseases. Indeed, they have anti-inflammatory, immunomodulating, anti-infective, antithrombotic, and metabolic effects...
May 8, 2018: Clinical Drug Investigation
https://www.readbyqxmd.com/read/29734937/primary-skull-base-lymphoma-manifestations-and-clinical-outcomes-of-a-great-imitator
#4
John P Marinelli, Mara C Modzeski, John I Lane, Jamie J Van Gompel, Janalee K Stokken, Gita Thanarajasingam, Matthew L Carlson
Objectives Primary skull base lymphoma (PSBL) represents a rare manifestation of extranodal lymphoma. Presenting with nonspecific symptomatology and imaging findings, PSBL often masquerades as more common cranial base pathology and thus can present a diagnostic challenge. The objectives of this study were to characterize the manifestations and clinical outcomes of PSBL. Study Design Case series and chart review. Setting Tertiary referral center. Subjects and Methods Review of 48 patients with PSBL treated between 1994 and 2016...
May 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29720030/concurrent-letm-and-nerve-root-enhancement-in-spinal-neurosarcoid-a-case-series
#5
Pojen Deng, Olga Krasnozhen-Ratush, Christopher William, Jonathan Howard
Spinal neurosarcoidosis is a rare form of neurosarcoid which can be challenging to diagnose given its clinical or radiographic findings are often indistinguishable from other causes of spinal demyelinating disease. We present a series of three patients with spinal neurosarcoid, all of whom demonstrated concurrent longitudinally enhancing transverse myelitis as well as spinal nerve root enhancement. These findings may be suggestive of spinal neurosarcoid and may help clinicians make the diagnosis as well as reduce the need for invasive biopsy...
May 1, 2018: Multiple Sclerosis: Clinical and Laboratory Research
https://www.readbyqxmd.com/read/29671151/an-atypical-case-of-neurosarcoidosis-presenting-with-neovascular-glaucoma
#6
REVIEW
Melissa Vereecken, Karolien Hollanders, Deborah De Bruyn, Virginie Ninclaus, Julie De Zaeytijd, Ilse De Schryver
BACKGROUND: Sarcoidosis, a multisystem, granulomatous disorder, sometimes manifests with a neuro-ophthalmic subtype. The latter can pose a diagnostic challenge, especially when ocular symptoms appear before systemic involvement, as the clinical picture then can be non-specific and systemic laboratory and standard imaging investigations can be negative. FINDINGS: A 71-year-old woman presented with a 4-month history of sudden-onset visual loss in the left eye. Slit lamp examination revealed anterior chamber cells, iris, and angle neovascularization...
April 18, 2018: Journal of Ophthalmic Inflammation and Infection
https://www.readbyqxmd.com/read/29653415/carotid-arteritis-causing-amaurosis-fugax-and-ischaemic-cerebrovascular-events-in-neurosarcoidosis
#7
D P Kidd, D J McCabe, T Wilhelm, M Galloway
OBJECTIVE: To present and review the vascular consequences of arteritis in neurosarcoidosis. PATIENT AND METHODS: neurosarcoidosis is typically an inflammatory disorder of the meninges surrounding the brain and spinal cord. Although inflammation of small and medium sized vessels is seen pathologically and vasculitis is occasionally described, a large intracerebral arteritis has not previously been reported. A few case reports exist, however, which describe the vascular consequences of large vessel compromise in the disorder...
March 22, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29613892/approach-to-myelopathy
#8
Tracey A Cho, Shamik Bhattacharyya
PURPOSE OF REVIEW: Myelopathy is commonly encountered in clinical practice and is associated with a large number of causes. This article reviews the anatomy of the spinal cord and discusses how the clinical findings, time course, and radiographic patterns can help to identify the causes of myelopathy. RECENT FINDINGS: Imaging observations such as MRI "pancake" gadolinium enhancement pattern with spondylotic myelopathy and subpial enhancement with neurosarcoidosis have improved diagnostic specificity...
April 2018: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/29601562/-neurosarcoidosis-diagnosis-clinical-picture-and-therapy
#9
REVIEW
Renata Hebel, Mirosława Dubaniewicz-Wybieralska, Anna Dubaniewicz
Sarcoidosis (SA) is a granulomatous, multisystem disease of unknown etiology. Most often the disease affects lungs and mediastinal lymph nodes, but it may occur in other organs. Neurosarcoidosis (NS) more commonly occurs with other sarcoidosis forms, in 1% of cases it involves only nervous system. Symptomatic NS occurs but on autopsy study up to 25% of cases are confirmed. NS can affect central nervous system: the brain, spinal cord and peripheral nerves, and muscles. The diagnosis of neurosarcoidosis facilitates diagnostic criteria: histopathological, imaging and cerebrospinal fluid examination, and clinical symptoms...
March 27, 2018: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29363557/neurosarcoidosis-associated-with-intracerebral-haemorrhage-a-challenge-in-diagnosis-and-management
#10
Mark Peter Maskery, Paul N Cooper, Adrian Pace
Sarcoidosis is an idiopathic multisystem granulomatous disorder of unknown cause. Nervous system involvement (central and/or peripheral) is uncommon, developing in 5%-10%. The presenting symptoms are variable, reflecting the level of involvement, and frequently fluctuate and progress. Diagnosing neurosarcoidosis in people with previously confirmed systemic disease may be relatively straightforward, but diagnosing primary neurosarcoidosis is challenging. Managing neurosarcoidosis is primarily consensus based; corticosteroid is its mainstay, alongside corticosteroid-sparing agents and emerging novel therapies...
January 23, 2018: Practical Neurology
https://www.readbyqxmd.com/read/29325956/rapid-onset-thoracic-myelopathy-due-to-an-epidural-sarcoid-like-lesion-in-a-pediatric-patient
#11
Michael A Galgano, Carlos R Goulart, Karen Chisholm, Melissa Hazen, Scellig Stone
BACKGROUND: Isolated intraspinal neurosarcoidosis is a rare clinical entity, with most reports describing intramedullary involvement in adults. CASE DESCRIPTION: We detail the case of a 9-year-old girl with rapid-onset compressive myelopathy secondary to a thoracic epidural lesion. Although pathologic diagnosis was challenging, a presumptive diagnosis of isolated extradural neurosarcoidosis was made in light of the patient's investigations and dramatic response to corticosteroids...
March 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29296633/pleocytosis-is-not-fully-responsible-for-low-csf-glucose-in-meningitis
#12
Maxime O Baud, Jeffrey R Vitt, Nathaniel M Robbins, Rafael Wabl, Michael R Wilson, Felicia C Chow, Jeffrey M Gelfand, S Andrew Josephson, Steve Miller
Objective: The mechanism of hypoglycorrhachia-low CSF glucose-in meningitis remains unknown. We sought to evaluate the relative contribution of CSF inflammation vs microorganisms (bacteria and fungi) in lowering CSF glucose levels. Methods: We retrospectively categorized CSF profiles into microbial and aseptic meningitis and analyzed CSF leukocyte count, glucose, and protein concentrations. We assessed the relationship between these markers using multivariate and stratified linear regression analysis for initial and repeated CSF sampling...
January 2018: Neurology® Neuroimmunology & Neuroinflammation
https://www.readbyqxmd.com/read/29284821/the-tale-of-the-storyteller-and-the-painter-the-paradoxes-in-nature
#13
Sadanandavalli Retnaswami Chandra, Lakshminarayanapuram Gopal Viswanathan, Rahul Wahatule, Safal Shetty
Introduction: Brain as the seat of behavior is acknowledged from the times of Charaka, however where neurology ends and philosophy begins remains an enigma. It is certainly every neurologist's observation that there is loss of function either region based or domain based in progressive diseases of the nervous system making it the seat of all useful activities. However, there are references to occurrence of new skills seen during various illnesses causing progressive cognitive dysfunction...
November 2017: Indian Journal of Psychological Medicine
https://www.readbyqxmd.com/read/29284603/cerebrovascular-manifestations-of-neurosarcoidosis-an-underrecognized-aspect-of-the-imaging-spectrum
#14
REVIEW
G Bathla, P Watal, S Gupta, P Nagpal, S Mohan, T Moritani
Involvement of the central nervous system by sarcoidosis, also referred to as neurosarcoidosis, is seen clinically in about 5% of patients with systemic disease. CNS involvement most frequently affects the leptomeninges and cranial nerves, though the ventricular system, brain parenchyma, and pachymeninges may also be involved. Even though the involvement of the intracranial vascular structures is well-known on postmortem studies, there is scant literature on imaging manifestations secondary to the vessel wall involvement, being confined mostly to isolated case reports and small series...
December 28, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29247071/evaluation-of-idiopathic-transverse-myelitis-revealing-specific-myelopathy-diagnoses
#15
Nicholas L Zalewski, Eoin P Flanagan, B Mark Keegan
OBJECTIVE: To evaluate specific myelopathy diagnoses made in patients with suspected idiopathic transverse myelitis (ITM). METHODS: A total of 226 patients 18 years and older were referred to Mayo Clinic Neurology for suspected ITM from December 1, 2010, to December 31, 2015. Electronic medical records were reviewed for detailed clinical presentation and course, laboratory and electrophysiologic investigations, and neuroimaging to determine the etiology. Current diagnostic criteria for ITM and alternative myelopathy diagnoses were applied...
January 9, 2018: Neurology
https://www.readbyqxmd.com/read/29190998/radiological-and-nuclear-medicine-imaging-of-sarcoidosis
#16
Anna R Larici, Andor W Glaudemans, Annemilia Del Ciello, Riemer H Slart, Lucio Calandriello, Olivier Gheysens
Sarcoidosis is a multisystem chronic inflammatory disease of unknown etiology characterized by widespread growth of non-caseating granulomas. The diagnosis of sarcoidosis is based on clinical and imaging presentation, histologic confirmation and the absence of alternative diseases. Radiology and Nuclear Medicine play an essential role in the diagnostic work-up of patients with sarcoidosis to assess disease extent and activity. In addition, imaging modalities have shown their potential in managing these patients in terms of treatment response and prognostic assessment...
March 2018: Quarterly Journal of Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/29166635/the-protean-neuropsychiatric-and-vestibuloauditory-manifestations-of-neurosarcoidosis
#17
Jacqueline J Greene, Ilka C Naumann, Janet M Poulik, Kevin T Nella, Lindsay Weberling, Jeffrey P Harris, Akihiro J Matsuoka
BACKGROUND: A rare subset of sarcoidosis, neurosarcoidosis, is reported to occur in 5-7% of sarcoid patients and can manifest in a variety of ways. The most common are facial paralysis and optic neuritis, less commonly causing cochleovestibulopathy, blindness, anosmia, and other cranial nerve (CN) palsies. The sensory deficit may be severe and psychiatric symptoms may result from the effects of the disease or steroid treatment. Although MRI-compatible cochlear implants are now available, concerns about the feasibility of recoverable hearing with cochlear implantation in these patients as well as the practical difficulty of disease monitoring due to implant artifact must be considered...
2017: Audiology & Neuro-otology
https://www.readbyqxmd.com/read/29141820/fulminant-intramedullary-spinal-cord-sarcoidosis
#18
Jonas Graf, Marius Ringelstein, Orhan Aktas, Mike P Wattjes, Hans-Peter Hartung
Neurosarcoidosis is a rare disease with various clinical phenotypes. Thus, case reports and series broaden the understanding of this entity (Ibitoye et al., 2017). We present a case of isolated intramedullary spinal cord sarcoidosis, an exceedingly rare phenotype, which needs to be distinguished especially from neuromyelitis optica spectrum disorders (NMOSD). This report exemplifies the need for a systematic approach to diagnosis and management of spinal cord sarcoidosis.
November 2017: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/29137054/case-report-middle-aged-woman-from-ghana-with-unsteady-gait-and-enlarging-cerebellar-mass
#19
Bharat Bajantri, Sindhaghatta Venkatram, Masooma Niazi, Tushi Singh, Gilda Diaz-Fuentes
RATIONALE: Neurosarcoidosis (NS) is an uncommon manifestation of systemic sarcoidosis, with a propensity for middle-agedwomen. Often discovered only at autopsy, rates of neurologic involvement (5%-10%) reported in the literature underscore a lack of sensitivity and specificity in current diagnostic methods. PATIENT CONCERNS: Herein, we describe a 53-year-old woman who presented with gait imbalance and distal extremity muscular weakness. She was known to harbor a brain mass (4 years in duration) that was monitored and recently seemed to enlarge...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29061245/neurosarcoidosis
#20
REVIEW
Patompong Ungprasert, Eric L Matteson
Neurosarcoidosis occurs in 3% to 10% of patients with sarcoidosis. Cranial neuropathy and meningeal involvement are the most common manifestations, but any part of the nervous system can be affected. Definite diagnosis requires the presence of noncaseating granuloma in the nervous system, although histopathologic confirmation is often not obtainable. Moderate to high dose of glucocorticoids is the main therapy for neurosarcoidosis. Relapse often occurs after the dose of glucocorticoids is tapered down, often necessitating the use of steroid-sparing immunosuppressive agents...
November 2017: Rheumatic Diseases Clinics of North America
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