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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cogan syndrome is a multisystem inflammatory vascular disease, characterized by nonsyphilitic interstitial keratitis and vestibuloauditory symptoms. Recent reports have directed attention to involvement of other organ systems. Respiratory, cardiovascular, gastrointestinal, and musculoskeletal problems are common, as are laboratory abnormalities and general symptoms such as fever, chills, and weight loss. Prominent neurologic problems in two patients prompted a review of 79 cases of Cogan syndrome. More than half had nervous system involvement, including electroencephalographic or spinal fluid abnormality, headache, psychosis, coma, convulsion, neuropathy, and stroke. Cogan syndrome should be considered when neurologic deficits are accompanied by eye, ear, and systemic symptoms.
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PMID:Neurologic manifestations of Cogan syndrome. 30 11

We report the case of a 25-year old man with vestibulocochlear and ocular impairment compatible with Cogan's syndrome. Later on, severe headache developed. CT scan showed an ischaemic lesion in the right frontal lobe. Magnetic resonance imaging demonstrated multiple bilateral nodular lesions on T2-weighted sequences. These were unmodified at a second MRI examination performed six months later. Under corticosteroids, the neurological and ophthalmic symptoms disappeared, but the patient remained deaf. We believe that this patient had vasculitis involving the brain, with infarcts. To our knowledge, no case of Cogan's syndrome with cerebral magnetic resonance imaging has yet been reported.
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PMID:[Magnetic resonance imaging and Cogan's syndrome]. 202 52

The purpose of this report is to describe the effective treatment of severe anterior segment inflammation due to Cogan syndrome through the use of topical administration of cyclosporin A. A 47-year-old female patient had been experiencing headaches and difficulties with her vision. Subsequent examination revealed the sudden onset of bilateral conjunctival injection and swelling of bilateral auricles. Despite the multiple treatment (systemic and topical corticosteroid and antibiotic therapy), necrotizing scleritis had appeared bilaterally and the scleral wall was thinning. Topical administration of 1% cyclosporin A was applied to both eyes 4 times a day. After 2 months of this therapy, the epithelial tissue covered the necrotizing tissue and her symptom of ocular pain was relieved and her corrected visual acuity was improved. This is the first case exhibiting that topical cyclosporin A is an effective treatment for severe anterior segment inflammation associated with Cogan syndrome.
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PMID:Effective treatment with topical cyclosporin A of a patient with Cogan syndrome. 1105 5

An 18-year-old woman was admitted to the medical center near her home with complaints of high fever and severe headache in June 1995. A diagnosis of adult-onset Still's disease was suspected and 50 mg/day of prednisolone was orally administered. In early April 1997, the patient suffered from sudden bilateral hearing loss and high fever. Pure tone audiogram taken at the same time showed an asymmetric bilateral neurosensorial hearing loss. A diagnosis of Cogan's syndrome was made. Administration of 60 mg prednisolone daily improved fever. Audiogram taken one month after administration of prednisolone showed improvement in the right ear. Monthly cyclophosphamide pulse therapy 700 mg combined with oral prednisolone was instituted. This combination therapy enabled the successful tapering of prednisolone without recurrence of hearing loss. Combined corticosteroid and pulse cyclophosphamide therapy would appear to be one effective regimen for Cogan's syndrome.
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PMID:Atypical Cogan's syndrome successfully treated with corticosteroids and pulse cyclophosphamide therapy. 1144 78

Cogan's syndrome is a rare autoimmune multisystem disease. The main clinical features of typical Cogan's syndrome are vestibuloauditory dysfunction and interstitial keratitis. The authors present a case of atypical Cogan's syndrome with headache, fever, deafness, trigeminal neuralgia and electroencephalographic abnormality which mimicked viral encephalitis.
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PMID:Atypical Cogan's syndrome mimicking encephalitis. 1530 93

A 63-year-old man presented with chronic headache and bilateral hearing loss. A physical examination showed bilateral conjunctivitis. Circulating anti-Cogan peptide antibodies were detected by dot blot analysis. He was diagnosed as having Cogan's syndrome (CS). Steroid therapy led to dramatic improvement of his symptoms and abnormal laboratory findings. During a tapering course of steroid therapy, he suffered from headache. An ophthalmoscopic examination revealed papillary edema. Magnetic resonance imaging of the brain showed hypertrophic cranial pachymeningitis (HCP). After steroid pulse therapy, HCP was improved. To our knowledge, this is the first case of CS complicated with HCP.
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PMID:Hypertrophic cranial pachymeningitis in a patient with Cogan's syndrome. 1821 35

Francisco Goya (1746-1828), a major Spanish artist, became profoundly deaf aged 46 years, following an acute illness. Despite this, his success continued and he eventually died aged 82 years. His illness is sketchily documented in letters written during his convalescence, describing headache, deafness, tinnitus, unsteadiness and visual disturbance with recovery (apart from deafness) over three months. There was a milder similar illness two years before, suggesting a relapsing condition. Vogt-Koyanagi-Harada syndrome, although previously accepted as Goya's diagnosis, is not supported by the limited evidence. Susac's syndrome or Cogan's syndrome, although both rare, are more likely explanations.
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PMID:Goya's deafness. 1960 77

Cogan's syndrome (CS) is an autoimmune disorder characterized by non-syphilitic interstitial keratitis and progressive audiovestibular impairment. Haynes et al. modified diagnostic criteria for patients with other ocular or vestibular symptoms and suggested this to be atypical CS. We report the case of a 71-year-old man with atypical CS. He was referred to our hospital with a headache, bilateral facial nerve palsy, left episcleritis and bilateral sensorineural hearing loss. Serological test results for syphilis and antineutrophil cytoplasmic autoantibodies were negative. Cerebral MRI revealed sinusitis and pituitary swelling. Contrast-enhanced computed tomography (CT) of the aorta demonstrated thickening of the wall and stenosis of the aorta with pathological uptake on fluorodeoxyglucose positron emission tomography. Biopsy of the sinus mucosa exhibited angiitis of the arterioles, capillaries, and venules. Atypical CS was diagnosed on the basis of episcleritis, progressive sensorineural hearing loss and exclusion of other inflammatory diseases. Intravenous injection of 500mg/day methylprednisolone for 3 days was effective for alleviating the patient's symptoms, except for hearing loss, but the disease recurred during the tapering of prednisolone (PSL). Combined therapy with PSL (10 mg/day) and methotrexate (6 mg/week) helped achieve remission of the disease. CS is causative of cranial polyneuropathy, but diagnosis of the former is not always straightforward as in the cases of cranial polyneuropathy. It has been considered that CS is a subtype of polyarteritis nodosa (PN); however, the clinical signs and size of the affected vessels in the present patient are different from those in PN. It is postulated that CS is a vasculitic syndrome that should be distinguishable from PN.
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PMID:[A case of atypical Cogan's syndrome with a steroid-responsive headache and multiple cranial neuropathy as the initial symptoms]. 2198 70

Background. Cogan's syndrome is a rare clinical entity whose etiopathology is still unknown, and the treatment strategies are not clearly defined. Case. A 23-year-old male presented with symptoms of headache, peripheral facial palsy, persistent right hearing loss and bilateral papillitis. Workup excluded all infectious, granulomatous, neoplastic, and immune causes. The diagnosis of atypical Cogan's syndrome was established, and the patient was treated with systemic corticosteroids and later on with cyclophosphamide and methotrexate. There were improvement of visual symptoms and stabilisation of left hearing. Conclusion. Cogan's syndrome is a very rare disease with no specific biological tests for the diagnosis. The diagnostic exams are mostly important to exclude other etiologies. The atypical ocular and audiovestibular manifestations make the diagnosis difficult, delaying the institution of appropriate therapy which may result in profound bilateral deafness.
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PMID:Atypical Cogan's Syndrome. 2369 87

Cogan's syndrome (CS) is a chronic inflammatory disorder of unknown etiology that most commonly affects young adults. Clinical hallmarks are bilateral interstitial keratitis and vestibuloauditory dysfunction. Association between CS and systemic vasculitis as well as aortitis also exists. The diagnosis of CS is based upon presence of characteristic inflammatory eye disease and vestibuloauditory dysfunction. We describe classic Cogan's syndrome in a 47-year-old female from Ardabil. The patient was admitted with headache, vertigo, nausea, vomiting, right leg claudication, musculoskeletal pains, bilateral hearing loss, and blindness for the past two months. Ophthalmologic examination revealed that visual acuity was 0.1 bilaterally. Conjunctival hyperemia, bilateral cataract, and interstitial keratitis were detected with a slit lamp examination. Pure tone audiogram (PTA) and auditory brain stem response (ABR) showed bilateral sensorineural hearing loss. The other differential diagnosis of CS was studied and ruled out. Pulse i.v. methylprednisolone and cyclophosphamide were given and were followed by oral prednisolone and cyclophosphamide. Clinical follow-up showed partial improvement.
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PMID:Interstitial Keratitis, Vertigo, and Vasculitis: Typical Cogan's Syndrome. 2471 22


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