Neurosarcoidosis.

[Neurosarcoidosis]. Radiologe. 2016 Sep 15; Authors: Reith W, Roumia S, Popp C Abstract CLINICAL/METHODICAL ISSUE: Neurosarcoidosis is a relatively rare complication of sarcoidosis that occurs in approximately 5-15 % of patients. The clinical picture is variable. Clinically, neurosarcoidosis is mostly manifested as lesions of the cranial nerves (50-70 %) and several cranial nerves are typically affected. This is the result of aseptic granulomatous basal meningitis. Intraparenchymal granulomas also occur, frequently affecting basal near-midline structures, such as the hypothalamus and pituitary glands and can lead to encephalopathy. STANDARD RADIOLOGICAL METHODS: Diagnostics are essentially performed using magnetic resonance imaging (MRI) as it can demonstrate the thickened meninges, which have a high affinity for contrast media but the results are not specific. Particularly in the absence of systemic sarcoidosis, diagnosis can be difficult. Laboratory tests are not very sensitive and specific, which makes neurosarcoidosis a diagnostic challenge. ACHIEVEMENTS: Due to the substantial morbidity of the disease, early and consistent treatment should be initiated. This is usually carried out with corticosteroids supported by immunosuppressant drugs, such as azathioprine and methotrexate. PMID: 27638827 [PubMed - as supplied by publisher]
Source: Der Radiologe - Category: Radiology Authors: Tags: Radiologe Source Type: research

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Abstract Neurosarcoidosis (NS) is an often severe, destructive manifestation with a likely under-reported prevalence of 5 to 15% of sarcoidosis cases, and in its active phase demands timely treatment intervention. Clinical signs and symptoms of NS are variable and wide-ranging, depending on anatomical involvement. Cranial nerve dysfunction, cerebrospinal parenchymal disease, aseptic meningitis, and leptomeningeal disease are the most commonly recognized manifestations. However, non-organ-specific potentially neurologically driven symptoms, such as fatigue, cognitive dysfunction, and small fiber neuropathy, appear ...
Source: Respiratory Care - Category: Respiratory Medicine Authors: Tags: Semin Respir Crit Care Med Source Type: research
Semin Respir Crit Care Med 2020; 41: 641-651 DOI: 10.1055/s-0040-1710576Neurosarcoidosis (NS) is an often severe, destructive manifestation with a likely under-reported prevalence of 5 to 15% of sarcoidosis cases, and in its active phase demands timely treatment intervention. Clinical signs and symptoms of NS are variable and wide-ranging, depending on anatomical involvement. Cranial nerve dysfunction, cerebrospinal parenchymal disease, aseptic meningitis, and leptomeningeal disease are the most commonly recognized manifestations. However, non-organ-specific potentially neurologically driven symptoms, such as fatigue, cogn...
Source: Seminars in Respiratory and Critical Care Medicine - Category: Respiratory Medicine Authors: Tags: Review Article Source Type: research
Conclusion Infliximab is an effective treatment in neurosarcoidosis leading to remission or improvement in 70%. The mortality rate in infliximab-treated patients was substantial, indicating the severity of disease and treatment-associated complications. Classification of evidence This study provides Class IV evidence that in people with pathology-confirmed neurosarcoidosis, infliximab is beneficial.
Source: Neurology Neuroimmunology and Neuroinflammation - Category: Neurology Authors: Tags: All Immunology, Class IV, Cohort studies Article Source Type: research
Conclusions CSF sIL-2R parameters are elevated in patients with neurosarcoidosis, but this finding is not specific for neurosarcoidosis. Nevertheless, CSF sIL-2R parameters may help distinguishing neurosarcoidosis from MS and are associated with clinical, radiologic, and CSF disease activity markers of neurosarcoidosis. Classification of evidence This study provides Class II evidence that CSF sIL-2R parameters distinguish neurosarcoidosis from NINDs and MS.
Source: Neurology Neuroimmunology and Neuroinflammation - Category: Neurology Authors: Tags: Article Source Type: research
Conclusions Recognition of the clinical features (chronically evolving myelopathy) and distinct MRI phenotypes (with enhancement in a subpial and/or meningeal pattern) seen in SAM can aid diagnosis of this disorder. Enhancement patterns suggest that SAM may have a predilection for areas of the spinal cord susceptible to mechanical stress.
Source: Neurology Neuroimmunology and Neuroinflammation - Category: Neurology Authors: Tags: MRI, All Spinal Cord, Transverse myelitis Article Source Type: research
Authors: Tattevin P, Tchamgoué S, Belem A, Bénézit F, Pronier C, Revest M Abstract Aseptic meningitis is defined as meningeal inflammation - i.e. cerebrospinal fluid (CSF) pleocytosis≥5 cells/mm3 - not related to an infectious process. Etiologies of aseptic meningitis can be classified in three main groups: (i) systemic diseases with meningeal involvement, which include sarcoidosis, Behçet's disease, Sjögren's syndrome, systemic lupus erythematosus and granulomatosis with polyangiitis; (ii) drug-induced aseptic meningitis, mostly reported with non-steroidal an...
Source: Revue Neurologique - Category: Neurology Tags: Rev Neurol (Paris) Source Type: research
Discussion Facial nerve palsy has been known for centuries, but in 1821 unilateral facial nerve paralysis was described by Sir Charles Bell. Bell’s palsy (BP) is a unilateral, acute facial paralysis that is clinically diagnosed after other etiologies have been excluded by appropriate history, physical examination and/or laboratory testing or imaging. Symptoms include abnormal movement of facial nerve. It can be associated with changes in facial sensation, hearing, taste or excessive tearing. The right and left sides are equally affected but bilateral BP is rare (0.3%). Paralysis can be complete or incomplete at prese...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news
Conclusions: Pseudomeningoceles following ONSF may be asymptomatic or may cause symptomatic orbital mass effect and rarely visual loss, amendable to surgical excision. Post-ONSF pseudomeningoceles are identified on computed tomography or magnetic resonance imaging to occur at the locations of fenestration sites and contain cerebrospinal fluid communicating with the subdural space that may act as a “filtration” bleb in some cases. Imaging findings may represent a spectrum spanning intraorbital cerebrospinal fluid leakage, partial walling off of bleb, or fully developed cysts. Resection of optic nerve pseudomen...
Source: Ophthalmic Plastic and Reconstructive Surgery - Category: Opthalmology Tags: Original Investigations Source Type: research
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog aka Tropical Travel Trouble 009 The diagnosis of HIV is no longer fatal and the term AIDS is becoming less frequent. In many countries, people with HIV are living longer than those with diabetes. This post will hopefully teach the basics of a complex disease and demystify some of the potential diseases you need to consider in those who are severely immunosuppressed. While trying to be comprehensive this post can not be exhaustive (as you can imagine any patient with ...
Source: Life in the Fast Lane - Category: Emergency Medicine Authors: Tags: Clinical Cases Tropical Medicine AIDS art cryptococcoma cryptococcus HIV HIV1 HIV2 PEP PrEP TB toxoplasma tuberculoma Source Type: blogs
The aim of this study was to determine the characteristics, treatment, and outcome according to each etiology of pachymeningitis. We conducted a retrospective multicenter French nationwide study between 2000 and 2016 to describe the characteristics, outcome, and treatment of pachymeningitis. We included 60 patients (median age 55.5 years; interquartile range [IQR] 30–80, female/male ratio 0.43). Neurologic signs were present in 59 patients (98%) and consisted of headache in 43 (72%), cranial nerve palsy in 33 (55%), confusion in 10 (17%), seizures in 7 (12%), and focal neurologic signs in 9 (15%). Fever and weight ...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
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