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Spinal cord sarcoidosis

O Fain, A Mekinian
Pachymeningitis is a fibrosing and inflammatory process, which involves the dura mater. Some pachymeningitis are cranial and induce headaches and cranial nerve palsies. Others are spinal and responsible for nerve roots or spinal cord compression. MRI shows contrast enhancement thickening of the dura mater. Etiologies are infectious (syphilis, tuberculosis, etc.) or inflammatory (sarcoidosis, granulomatosis with polyangiitis, IgG4-related disease, idiopathic). Corticosteroids are the main treatment. The use of immunosuppressive drugs or rituximab is yet to be determined and probably adapted to each etiology...
April 13, 2017: La Revue de Médecine Interne
Ashok Kumar Kayal, Munindra Goswami, Marami Das, Lakhshya Jyoti Basumatary, Suvorit Subhas Bhowmick, Baiakmenlang Synmon
BACKGROUND: The discovery of antibodies against aquaporin-4 and evolving concepts of noncompressive myelopathies in the 21(st) century have made a major impact on the etiological profile of these diseases, with few cases turning out to be idiopathic. OBJECTIVE: To find causes of noncompressive myelopathy in a tertiary care hospital of Northeast India. MATERIALS AND METHODS: An observational study was carried out in the Neurology Department of Gauhati Medical College, Guwahati, from September 2013 to February 2016...
January 2017: Annals of Indian Academy of Neurology
Fleur Cohen Aubart, Diane Bouvry, Damien Galanaud, Caroline Dehais, Guillaume Mathey, Dimitri Psimaras, Julien Haroche, Corinne Pottier, Miguel Hie, Alexis Mathian, Hervé Devilliers, Hilario Nunes, Dominique Valeyre, Zahir Amoura
Central nervous system localizations of sarcoidosis may be refractory to conventional treatment such as steroids and immunosuppressive drugs. Infliximab, a TNF-α antagonist chimeric antibody, has been shown to be effective for treatment of these localizations. The aim of this study was to evaluate the efficacy and safety, in particular the long-term outcomes, of the use of infliximab for the treatment of neurosarcoidosis. We retrospectively reviewed medical records of patients with neurosarcoidosis who had been treated with infliximab between 2009 and 2015...
March 4, 2017: Journal of Neurology
K O'Connell, L Williams, J Jones, D J H McCabe, D Murphy, R Killeen, N Tubridy, S O'Riordan, C McGuigan
BACKGROUND: The clinical manifestations of neurosarcoidosis are highly variable and it should be considered as a potential differential diagnosis in any neurological presentation. AIM: This study was designed to describe the clinical, diagnostic, and treatment patterns and functional outcome in a Caucasian neurosarcoidosis population. DESIGN: A retrospective analysis was performed on prospectively recorded data in patients attending our neurology clinic between 2008 and 2014 with a diagnosis of definite or probable neurosarcoidosis according to Zajiek criteria...
January 18, 2017: Irish Journal of Medical Science
Atsuhiko Sugiyama, Makoto Kobayashi, Kumiko Agatsuma, Takeshi Bo, Toshiaki Shiojiri, Hidetoshi Mochida, Yoshio Suzuki, Takashi Matsunaga, Satoshi Kuwabara
A 61-year-old woman presented with a 10-month history of gait disturbance and a 7-month history of urinary incontinence. The Hasegawa dementia scale-revised score indicated cognitive impairment. Brain magnetic resonance imaging (MRI) indicated hydrocephalus with disproportionately enlarged subarachnoid space. This is usually considered a characteristic finding in idiopathic normal pressure hydrocephalus (iNPH). Ventriculo-peritoneal shunting improved the patient's symptoms. Neurosarcoidosis was suspected as a cause of the hydrocephalus because of the abnormalities in the cerebrospinal fluid and the abnormal enhancement of the cauda equina, the leptomeninges of the brainstem, and the spinal cord, as seen on MRI with gadolinium enhancement...
December 2016: Brain and Nerve, Shinkei Kenkyū No Shinpo
R Patejdl, M Wittstock, U K Zettl, K Jost, A Grossmann, J Prudlo
INTRODUCTION: Recently defined consensus criteria for the diagnosis of neuromyelitis optica spectrum disorders (NMOSD) allow establishing the diagnosis in patients without elevated AQP4-Ab and optic nerve involvement. According to the new extended definition, NMOSD is closely associated with extensive spinal cord inflammation occurring in the course of systemic autoimmune diseases as sarcoidosis or lupus erythematodes. NMOSD occurring in the course of hematological disease have not yet been reported in the literature...
September 2016: Multiple Sclerosis and related Disorders
Nicholas L Zalewski, Karl N Krecke, Brian G Weinshenker, Allen J Aksamit, Brittani L Conway, Andrew McKeon, Eoin P Flanagan
No abstract text is available yet for this article.
August 16, 2016: Neurology
Joshua P Klein
Myelitis, or inflammation of the spinal cord, produces a characteristic clinical syndrome. Among the many causes of myelitis are the prototypical demyelinating diseases multiple sclerosis and neuromyelitis optica, each of which has distinct clinical, pathologic, and radiographic features. Less distinct are the myelitides associated with systemic autoimmune conditions like sarcoidosis and lupus. Nondemyelinating conditions such as arachnoiditis, dural arteriovenous fistula, and tumor infiltration may also produce inflammation of the spinal cord...
2016: Handbook of Clinical Neurology
Stefano Palmucci, Sebastiano Emanuele Torrisi, Daniele Carmelo Caltabiano, Silvia Puglisi, Viviana Lentini, Emanuele Grassedonio, Virginia Vindigni, Ester Reggio, Riccardo Giuliano, Giuseppe Micali, Rosario Caltabiano, Cosma Andreula, Pietro Valerio Foti, Giovanni Carlo Ettorre, Simon Lf Walsh, Carlo Vancheri
UNLABELLED: The aim of this manuscript is to describe radiological findings of extra-pulmonary sarcoidosis. Sarcoidosis is an immune-mediated systemic disease of unknown origin, characterized by non-caseating epitheliod granulomas. Ninety percent of patients show granulomas located in the lungs or in the related lymph nodes. However, lesions can affect any organ. Typical imaging features of liver and spleen sarcoidosis include visceromegaly, with multiple nodules hypodense on CT images and hypointense on T2-weighted MRI acquisitions...
August 2016: Insights Into Imaging
Maciej Horyniecki, Marta Konieczna, Magdalena Torbus, Krystyna Pierzchała, Maciej Wawrzyńczyk, Beata Łabuz-Roszak
Neurosarcoidosis (NS) manifests itself clinically in approximately 8-13% of patients with sarcoidosis. Granulomas are localized in both the central and peripheral nervous system, mainly within the meninges and cranial nerves. Changes may spread interstitially, occupying different structures of the brain and spinal cord. Diagnosis of NS is made by characteristic clinical symptoms and the exclusion of other diseases, with the presence of specific changes in the magnetic resonance and cerebrospinal fluid, and it is mainly based on histopathological examination...
2016: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Eoin P Flanagan
Autoimmune myelopathies are a heterogeneous group of immune-mediated spinal cord disorders with a broad differential diagnosis. They encompass myelopathies with an immune attack on the spinal cord (e.g., aquaporin-4-IgG (AQP4-IgG) seropositive neuromyelitis optica (NMO) and its spectrum disorders (NMOSD)), myelopathies occurring with systemic autoimmune disorders (which may also be due to coexisting NMO/NMOSD), paraneoplastic autoimmune myelopathies, postinfectious autoimmune myelopathies (e.g., acute disseminated encephalomyelitis), and myelopathies thought to be immune-related (e...
2016: Handbook of Clinical Neurology
Cécile-Audrey Durel, Romain Marignier, Delphine Maucort-Boulch, Jean Iwaz, Emilie Berthoux, Marc Ruivard, Marc André, Guillaume Le Guenno, Laurent Pérard, Jean-François Dufour, Alin Turcu, Jean-Christophe Antoine, Jean-Philippe Camdessanche, Thierry Delboy, Pascal Sève
Sarcoidosis of the spinal cord is a rare disease. The aims of this study are to describe the features of spinal cord sarcoidosis (SCS) and identify prognostic markers. We analyzed 20 patients over a 20-year period in 8 French hospitals. There were 12 men (60 %), mostly Caucasian (75 %). The median ages at diagnosis of sarcoidosis and myelitis were 34.5 and 37 years, respectively. SCS revealed sarcoidosis in 12 patients (60 %). Eleven patients presented with motor deficit (55 %) and 9 had sphincter dysfunction (45 %)...
May 2016: Journal of Neurology
Elia Sechi, Alberto Addis, Rosanna Piredda, Anna Laura Rassu, GianFranco Mameli, Chiara Senes, GianPietro Sechi
No abstract text is available yet for this article.
May 1, 2016: JAMA Neurology
O Göhl, D J Walker, S Walterspacher, D Langer, C M Spengler, T Wanke, M Petrovic, R-H Zwick, S Stieglitz, R Glöckl, D Dellweg, H-J Kabitz
Specific respiratory muscle training (IMT) improves the function of the inspiratory muscles. According to literature and clinical experience, there are 3 established methods: 1.) resistive load 2.) threshold load and 3.) normocapnic hyperpnea. Each training method and the associated devices have specific characteristics. Setting up an IMT should start with specific diagnostics of respiratory muscle function and be followed by detailed individual introduction to training. The aim of this review is to take a closer look at the different training methods for the most relevant indications and to discuss these results in the context of current literature...
January 2016: Pneumologie
Eoin P Flanagan, Timothy J Kaufmann, Karl N Krecke, Allen J Aksamit, Sean J Pittock, B Mark Keegan, Caterina Giannini, Brian G Weinshenker
OBJECTIVE: To compare longitudinally extensive myelitis in neuromyelitis optica spectrum disorders (NMOSD) and spinal cord sarcoidosis (SCS). METHODS: We identified adult patients evaluated between 1996 and 2015 with SCS or NMOSD whose first myelitis episode was accompanied by a spinal cord lesion spanning ≥3 vertebral segments. All NMOSD patients were positive for aquaporin-4-immunoglobulin G, and all sarcoidosis cases were pathologically confirmed. Clinical characteristics were evaluated...
March 2016: Annals of Neurology
Shinichiro Yamada, Hirotaka Nakanishi, Masaaki Hirayama, Masahisa Katsuno, Gen Sobue
A 70-year-old woman was admitted to our hospital because of the right limb pain and gait disturbance. (67)Ga scintigraphy showed an increased uptake in the spinal cord, mediastinal lymph node and right tibialis anterior muscle. Based on the histopathological findings of epithelioid cell granuloma in endobronchial ultrasound-guided transbronchial needle aspiration of lymph node, she was diagnosed as having probable spinal cord/muscular sarcoidosis. After she was treated with oral prednisolone, her limb pain and gait disturbance improved...
2015: Rinshō Shinkeigaku, Clinical Neurology
Lei Wang, Yuebing Li
OBJECTIVE: To analyze the clinical characteristics and outcome of patients with neurosarcoidosis manifesting as longitudinal transverse myelitis spanning 6 or more spinal segments. METHOD: Retrospective analysis of 7 cases from a single institution. RESULTS: Four males and 5 African-American were included. The mean onset age for neurological symptoms was 49.1 years old. Only 1 patient had a prior diagnosis of sarcoidosis. In all patients, spinal MRI showed contiguous cervical and/or thoracic cord lesions predominantly in a central or centrodorsal location, associated with parenchymal or leptomeningeal gadolinium enhancement...
August 15, 2015: Journal of the Neurological Sciences
Nagina Subrati, Babar Vaqas, David Peterson, Maneesh C Patel
We describe a case of a 58-year-old woman with a suspected dural tumour. She presented with progressive pyramidal weakness. MRI confirmed compression of the medulla oblongata and spinal cord at the level of C1-3. The localised dural mass lesion homogenously enhanced on T1 MRI and was considered most likely to be a meningioma. Incidentally, CT scan of the chest revealed peribronchial soft tissue thickening, suggestive of pulmonary sarcoidosis. Owing to the progressive nature of her weakness, she had a posterior occipitocervical decompression with a C1-3 laminectomy and resection of the thickened dura...
2015: BMJ Case Reports
Douglas A Simonetto, Konstantinos A Papadakis
No abstract text is available yet for this article.
May 2015: Gastroenterology
Dhiraj Baruah, Tushar Chandra, Manish Bajaj, Purabi Sonowal, Andrew Klein, Mohit Maheshwari, Saurabh Guleria
Neuroimaging is indispensable for evaluation of Myelopathy not only for localization but also for etiologic determination. MRI is the preferred examination for further characterization of the majority of these conditions. These include traumatic, inflammatory, infections, compressive and neoplastic conditions. This article provides an overview of a variety of pathologies that afflict the spinal cord in an easy to understand format. Their respective imaging manifestations on MRI and differential diagnoses are focused in this review...
May 2015: Current Problems in Diagnostic Radiology
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