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Neuro sarcoidosis

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
Haben Kefella, Daniel Luther, Clotilde Hainline
PURPOSE OF REVIEW: Sarcoidosis is a multisystemic inflammatory disease that commonly affects the eye and less often the neuro-ophthalmic pathways. The manifestations can be quite variable but can have characteristic signs and clinical features. This review provides a comprehensive overview of the various ocular and neuro-ophthalmic manifestations of sarcoidosis, emerging diagnostic measures and approach to treatment. Particular focus is given to recent advances in diagnostic approach and available treatment options...
November 2017: Current Opinion in Ophthalmology
Richard T Ibitoye, A Wilkins, N J Scolding
Sarcoidosis is a rare but important cause of neurological morbidity, and neurological symptoms often herald the diagnosis. Our understanding of neurosarcoidosis has evolved from early descriptions of a uveoparotid fever to include presentations involving every part of the neural axis. The diagnosis should be suspected in patients with sarcoidosis who develop new neurological symptoms, those presenting with syndromes highly suggestive of neurosarcoidosis, or neuro-inflammatory disease where more common causes have been excluded...
May 2017: Journal of Neurology
Aleksandra Radosavljević, Vesna Jakšić, Lato Pezo, Dragana Kovačević-Pavićević, Aleksandra Ilić, Violeta Mihailović Vučinić
PURPOSE: To analyze clinical characteristics of ocular sarcoidosis in a group of biopsy-proven sarcoid patients treated at the single referral center for sarcoidosis in Serbia. METHODS: A prospective study carried out on 88 biopsy-proven sarcoid patients between January 2012 and December 2014. All patients underwent complete ophthalmological examination. RESULTS: Ocular sarcoidosis was present in 32 patients (36.4% of all) and included: eyelid skin lesions (2...
December 2017: Ocular Immunology and Inflammation
Nelly Ougier, Pascal Roux, Cédric Lamirel, Emilie Tournaire-Marques, Yacine Tandjaoui-Lambiotte, Olivier Gout, Romain Deschamps
No abstract text is available yet for this article.
March 2015: Clinical Neurology and Neurosurgery
Larry P Frohman
BACKGROUND: Because of the rarity of neuro-ophthalmic sarcoidosis, there are no therapeutic guidelines based on evidence-based medicine for this disorder. EVIDENCE ACQUISITION: Review of literature combined with personal experience. RESULTS: Corticosteroids are the preferred initial therapy for neuro-ophthalmic sarcoidosis. If patients cannot tolerate the requisite dose of corticosteroid needed to control their disease, or if corticosteroids fail to adequately control the disease process, the choices of a second agent are based on the consideration of rapidity of clinical response and the safety profile...
March 2015: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
John J Chen, Fiona Costello, Randy H Kardon
Many neuro-ophthalmic diseases have a clear sex predilection, which is important to recognize in making the diagnosis based on risk stratification and understanding the pathogenesis of the disease. This review discusses the more common neuro-ophthalmic diseases with a female predilection, including idiopathic intracranial hypertension, cerebral venous sinus thrombosis, meningioma, multiple sclerosis, migraine, breast-cancer associated neuro-ophthalmic manifestations, sarcoidosis, bisphosphonate-associated orbital inflammation, and pregnancy-related neuro-ophthalmic disorders...
February 2015: Current Eye Research
Anne Vital, Claude Vital
Simultaneous combined superficial peroneal nerve and peroneous brevis muscle biopsy, via the same cutaneous incision, allows examination of several tissue specimens and significantly improves the diagnosis of systemic diseases with peripheral nerve involvement. Vasculitides are certainly the most frequently diagnosed on neuro-muscular biopsies, but this procedure is also well advised to asses a diagnosis of sarcoidosis or amyloidosis. More occasionally, combined nerve and muscle biopsy may reveal an unpredicted diagnosis of cholesterol embolism, intra-vascular lymphoma, or enables complementary diagnosis investigations on mitochondrial cytopathy or storage disease...
May 2014: Clinical Neuropathology
N Noel, A Drier, B Wechsler, J-C Piette, R De Paz, D Dormont, P Cacoub, D Saadoun
Neurological manifestations of Behçet's disease (BD) occur in 5.3 to more than 50% of patients. They are divided into two major forms: "parenchymal" lesions, which include mainly meningoencephalitis as opposed to "extra-parenchymal" lesions (i.e. cerebral venous thrombosis and arterial aneurysms). Myelitis or peripheral neuropathy is exceptional. The neuro-Behçet syndrome (NBS) should be considered in the setting of neurological manifestations, particularly headache and pyramidal signs, in a young man diagnosed with BD...
February 2014: La Revue de Médecine Interne
M Gallucci, J D Smith, N Limbucci, A Rossi, P Demaerel, T Krings, A D'Amico, C Micheli
Some rare neurological diseases affecting children have no well defined etiology and pathogenetic mechanisms. In this article diseases like Reye syndrome, Behçet disease, pediatric neurosarcoidosis, Posterior Reversible Encephalopathy Syndrome are described. Some of the main neuroradiological differential aspects are also critically considered. Reye syndrome is characterized by symmetric thalamic, white matter and basal ganglia lesions, in children with recent history of salycilates or immunosuppressive drugs intake...
December 20, 2012: Neuroradiology Journal
C Bezo, S Majzoub, Y Nochez, S Leruez, J-F Charlin, D Milea, P-J Pisella
INTRODUCTION: The purpose of this study was to describe the diagnostic strategy and therapeutic approach when sarcoidosis of the visual pathways is suspected, by way of a descriptive study of sarcoidosis patients in the ophthalmology services in Tours, Rennes and Angers. PATIENTS AND METHODS: A multicenter, retrospective chart review was performed for 30 patients diagnosed with sarcoidosis and followed at the university hospitals of Tours, Rennes and Angers between January 1997 and August 2011...
June 2013: Journal Français D'ophtalmologie
H Baallal, A C El Asri, B Eljebbouri, A Akhaddar, M Gazzaz, B El Mostarchid, M Boucetta
The fungus Cryptococcus neoformans can cause common opportunistic infection in acquired immune deficiency syndrome (AIDS) patients. But other conditions can be associated with sarcoidosis. Meningoencephalitis is the most common manifestation of this disease. One of the most important neurological complications is the development of intracranial hypertension (ICH), which may result in high morbidity and mortality. We report the case of a patient harboring a ventriculoperitoneal shunt, and having contracted a cryptococcal meningitis as a risk factor for pulmonary sarcoidosis...
February 2013: Neuro-Chirurgie
Roderich Meckenstock, Audrey Therby, Catherine Chapelon-Abric, Chantal Nifle, Jean Paul Beressi, Constance Lebas, Alix Greder-Belan
There are many similarities between mycobacteriosis, in particular, tuberculosis, and sarcoidosis such as predominant intrathoracic localisation (even if all organs and tissues may be concerned), great variability of phenotypic expression, and granulomatous inflammatory reaction, caseous necrosis not being an absolute criterion of tuberculosis. Moreover, microbial (or mycobacterial?) agents may play a role in the pathogenesis of sarcoidosis which remains a diagnosis of exclusion particularly in atypical cases...
2011: BMJ Case Reports
Desmond Kidd
In the first part of this chapter the anatomy and vascular supply of the chiasm are recounted, and the visual symptoms that may arise in chiasmal disease are noted. The neuro-ophthalmic signs, including the pattern of visual field defects, appearance of the optic disc, and various uncommon clinical accompaniments, are described. The second part deals with a comprehensive list of disease processes that may directly or indirectly affect the chiasm. These are divided into inflammatory disorders, including sarcoidosis, multiple sclerosis, and idiopathic chiasmitis; infective disorders, including tuberculosis; and a large section on tumors, including pituitary adenomas, cysts, and choristomas, malignant disorders, including germ cell tumors and glioma, and meningioma; and finally vascular disorders and compression due to hydrocephalus...
2011: Handbook of Clinical Neurology
Giovanni Quarta, Diana R Holdright, Gordon T Plant, Allan Harkness, Derek Hausenloy, Harpreet Hyare, James C Moon
Cardiovascular implantable electronic devices represent important limitations to magnetic resonance imaging (MRI). Recently, MRI-conditional dual chamber pacemakers and leads have become available. We describe a case of a patient with neuro-sarcoidosis presenting with diplopia and hydrocephalus requiring an MRI-conditional programmable ventriculo-peritoneal shunt, who developed complete heart block. In view of the ongoing need for neuro-imaging, MRI-conditional dual chamber pacemaker and leads were implanted...
2011: Journal of Cardiovascular Magnetic Resonance
Norman Saffra, Elizabeth Kaplow, Irina Mikolaenko, Alice Kim, Benjamin Rubin, Jafar Jafar
BACKGROUND: Pituitary adenoma may present with neuro-ophthalmic manifestations and, typically, rapid tumor expansion is the result of apoplexy. Herein, we present the first case of an isolated sixth cranial nerve palsy as initial feature of a rapidly expanding ACTH positive silent tumor without apoplexy. CASE PRESENTATION: A 44 year old female with a history of sarcoidosis presented with an isolated sixth cranial nerve palsy as the initial clinical feature of a rapidly expanding ACTH positive silent pituitary adenoma...
2011: BMC Ophthalmology
Robert Pichler, Gabriele Wurm, Karin Nussbaumer, Ognian Kalev, René Silyé, Serge Weis
No abstract text is available yet for this article.
December 20, 2010: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Yanny L Phillips, Eric R Eggenberger
PURPOSE OF REVIEW: Almost 100 years after its original description, sarcoidosis remains an enigmatic disease with unclear etiology and capricious symptomology, as well as a diagnostic challenge. This review coalesces current literature on the neuro-ophthalmic manifestations of sarcoidosis and discusses the epidemiology, etiology, clinical presentation, diagnosis, and management of this disease. RECENT FINDINGS: Recent investigations strongly identify a genetic component as well as a host of candidate antigenic triggers...
November 2010: Current Opinion in Ophthalmology
Okechukwu A Anakwenze, Vamsi Kancherla, Michael Hatch, John S Brooks, Christian M Ogilvie
Sarcoidosis is a well-described clinical entity with several types of presentation among different organ systems. However, primary musculoskeletal manifestation is a rare and seldom-described manifestation. A retrospective review of patients seen at our institution from 1999 to 2009 was performed to identify patients with such presentation. Eleven patients with musculoskeletal sarcoidosis were identified. Seven patients presented with solitary lesions, while 4 presented with multiple foci of disease. Histologically, all lesions revealed granulomatous inflammation consistent with sarcoidosis...
May 12, 2010: Orthopedics
M Titlic, M Bradic-Hammoud, L Miric, A Punda
Sarcoidosis is a chronic disease of unknown aetiology. Neurosarcoidosis is registered in 5% of patients with sarcoidosis. Clinical manifestations of sarcoidosis are numerous and diverse. Manifestation of Neurosarcoidosis includes partial- and grand-mal seizures, low-grade fever, headache, increased intracranial pressure, visual disturbances, diabetes insipidus, amenorrhea- galacterorrhea syndrome and pituitary failure, hypogonadotropic hypogonadism, hyperprolactinemia, unilateral and bilateral facial palsy, infiltration of meninges (aseptic meningitis) and nerve roots, leptominingitis, pachymeningitis with cranial neuropathies, pseudotumor, mild cognitive disorder, psychosis, delirium, dementia, disorientation, amnesia, progressive visual deterioration and proptosis, axonal polyneuropathies, mononeuropathies, chronic polyradiculoneuritis, peripheral neuropathy, cranial nerve abnormalities, radiculopathies, peripheral neuropathy, mononeuritis multiplex, progressive numbness and deep sensation disturbance in bilateral lower extremities, hemiplegia, hyperreflexia with pathological reflexes and hypesthesia, upward gaze palsy, spinal cord compression, dysarthria, dysphagia, weakness, episodes of blurred vision, diplopia, intracerebral hemorrhage, neuro-ophthalmic manifestations, intranuclear ophthalmoplegia, dysorientation, vasculitis presenting with strokes, intracranial hypothalamic lesion, paresthesis, hemiparesis, myelopathy in the cervico-thoracic region, lumbar pain, sensory level and inability of lateral gaze (Tab...
2009: Bratislavské Lekárske Listy
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