Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0029089 (ophthalmoplegia)
 3,338 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We describe a 63-year-old Afro-Caribbean female who presented with complete ophthalmoplegia of the right eye. Magnetic resonance imaging revealed a mass in the cavernous sinus, which was pathologically confirmed as due to sarcoidosis. No clinical or laboratory evidence of sarcoidosis was found in any other organs. We believe this is the first reported case of an isolated cavernous sinus syndrome due to sarcoidosis and suggest that sarcoidosis should be considered in the differential diagnosis of cavernous sinus syndromes even in the absence of systemic involvement of sarcoidosis.
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PMID:Cavernous sinus syndrome as the only manifestation of sarcoidosis. 1221 94

Painful ophthalmoplegia is an important presenting complaint to emergency departments, ophthalmologists, and neurologists. The etiological differential diagnosis of painful ophthalmoplegia is extensive and consists of numerous sinister etiologies including vascular (eg, aneurysm, carotid dissection, carotid-cavernous fistula), neoplasms (eg, primary intracranial tumors, local or distant metastases), inflammatory conditions (eg, orbital pseudotumor, sarcoidosis, Tolosa-Hunt syndrome), infectious etiologies (eg, fungal, mycobacterial), and other conditions (eg, microvascular infarcts secondary to diabetes, ophthalmoplegic migraine, giant cell arteritis). A systematic approach to the evaluation of painful ophthalmoplegia can lead to prompt recognition of serious disorders that if left untreated, can be associated with significant morbidity or mortality. Inflammatory conditions such as Tolosa-Hunt syndrome and orbital pseudotumor are highly responsive to corticosteroids, but should be diagnoses of exclusion.
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PMID:Painful ophthalmoplegia: overview with a focus on Tolosa-Hunt syndrome. 1522 94

Sarcoidosis is a multisystemic granulomatous disease of unknown etiology which affects most frequently the hilar lymph nodes and lungs. Symptomatic involvement of the central nervous system may develop in patients diagnosed with sarcoidosis or it may be the initial manifestation of the disease. This is a case report of 48-year old female patient admitted to our clinic for evaluation of working ability. The patient had a total of 24 years of service and occupational exposure and she has been employed as supplies procurement officer. On admission, she complained of the following discomforts: eye-lid pain, intellectual fatigue, psychic uneasiness, forgetfulness, dyspnea and productive cough. Neurological findings indicated the presence of the right eye ophthalmoplegia, psychoorganic syndrome and neurosarcoidosis. Ophthalmological examination evidenced bilateral ptosis and presence of anisocoria. Magnetic resonance imaging revealed discrete focal lesions of the pons (paracentral left) and parietal corona radiata of the left hemisphere. Based on performed examinations and diagnostics procedures, final evaluation of patient's working ability concluded that the patient was not capable of psychic strains and jobs associated with material accountability.
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PMID:[Work ability evaluation in neurosarcoidosis--a case report]. 1697 13

Two cases of uncommon manifestation of central nervous system sarcoidosis are reported. A 42 year-old man had a spinal cord sarcoidosis. MRI of the spinal cord showed myelopathy in the cervico-thoracic region, and the T2-weighted image showed increasing signal intensity. Neurological symptoms did not correlate with radiological abnormalities. Neurological manifestation was paucisymptomatic. Half a year later steroid and azathioprine therapy led to almost complete radiological and clinical regression. In the second case we present a 49 year-old woman who had left side internuclear ophthalmoplegia and the brainstem lesion. The patient was proven to have sarcoidosis. In this case no abnormalities were found in brain MRI. Neurological symptoms could not be detected by MRI, probably caused by brainstem parenchymal lesions consisting of microgranulomatosis that is sarcoid "brainstem encephalitis". Neurological symptoms improved after steroid treatment in this case too. In both of the cases pulmonary lymphadenopathy helped to diagnose sarcoidosis. In our cases there were interesting correlations between neurological symptoms and MRI abnormalities. At the spinal cord sarcoidosis the radiological abnormalities were more striking than the clinical manifestation. In the other case we found distinct brainstem symptoms but could not detect MRI abnormalities.
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PMID:[Uncommon manifestation of central nervous system sarcoidosis]. 1743 94

The differential diagnosis of painful ophthalmoplegia is extensive and consists of numerous sinister etiologies, including neoplasms (ie, primary intracranial tumors, local or distant metastases), vascular (eg, aneurysm, carotid dissection, and carotid-cavernous fistula), inflammatory (ie, orbital pseudotumor, giant cell arteritis, sarcoidosis, and Tolosa-Hunt syndrome), and infectious etiologies (ie, fungal and mycobacterial), as well as other miscellaneous conditions (ie, ophthalmoplegic migraine and microvascular infarcts secondary to diabetes). A systematic approach to the evaluation of painful ophthalmoplegia can lead to prompt recognition of serious disorders that can be associated with significant morbidity or mortality if left untreated. Inflammatory conditions such as Tolosa-Hunt syndrome and orbital pseudotumor are highly responsive to corticosteroids but should be diagnoses of exclusion.
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PMID:An approach to the patient with painful ophthalmoplegia, with a focus on Tolosa-Hunt syndrome. 1768 98

A rare case of neurosarcoidosis presenting as an isolated quadrigeminal plate mass without systemic manifestation of this disease is reported. This 26-year-old man presented with symptoms of acute intracranial hypertension including headache, morning vomiting as well as a right homonymous hemianopsia. Magnetic resonance imaging (MRI) showed an expansive tectal mass causing hydrocephalus secondary to an aqueductal obstruction. An external ventricular drainage was inserted and the mass, postulated to be a glioma, was removed through an occipital transtentorial craniotomy. Histopathological examination revealed numerous sarcoid granulomas. Postoperative course was relevant for bilateral hypoacusis and tinnitus, blurred vision, bilateral palpebral ptosis and bilateral internuclear ophthalmoplegia. Chest X-ray was normal. Postoperative thoracic computed tomography (CT) scan showed mediastinal adenopathies. Lung function tests were normal. Angiotensin converting enzyme (ACE) cerebrospinal fluid (CSF) blood ratio was normal. Postoperative treatment and follow-up included corticosteroids, serial lung function tests and cerebral MRI. Neurosarcoidosis may present with protean clinical manifestations and unusual radiological features. This rare diagnosis has to be kept in mind when facing isolated intracerebral mass lesions.
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PMID:Neurosarcoidosis presenting as an isolated mass of the quadrigeminal plate. 1863 66

A 65 year old male, presented with ophthalmoplegia and reduced vision in his left eye. The magnetic resonance imaging (MRI) of the brain revealed three hyperintensity areas located in the left parasellar area, left lacrimal gland and right frontal bone. Chest CT revealed bilateral pulmonary masses. The pathological diagnosis was necrotizing granuloma and vasculitis. Nine months after the diagnosis, the right eye was involved. This case report presents a rare manifestation of blinding necrotizing sarcoid granulomatosis that had responded to steroid therapy, but had a relapsing clinical course.
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PMID:[Ophthalmoplegia and blindness associated with necrotizing sarcoid granuloma]. 1877 Sep 55

Neurosarcoidosis, rare in patients with sarcoidosis, may present with protean manifestations according to the regions of involvement from peripheral nerves to the central nervous system. Cavernous sinus is rarely involved by sarcoidosis, and it can result in different cavernous sinus syndromes based mainly on the involvement of the trigeminal nerve. We report a 54-year-old man with pulmonary sarcoidosis and cavernous sinus syndrome and review the clinical course, laboratory findings, and neuroradiologic features of the condition. This patient presented with complete ophthalmoplegia of left eye. Magnetic resonance imaging revealed a lesion with gadolinium-enhancement in the left cavernous sinus. Serial chest examinations showed bilateral hilar enlargement. Pulmonary sarcoidosis was diagnosed according to the findings of lymph nodes biopsies. Elevated erythrocyte sedimentation rate and serum angiotension converting enzyme level were observed. After steroid administration, his ocular palsy ameliorated in a few days and cavernous sinus lesion completely disappeared within 3 months after treatment. Although rare, neurosarcoidosis should be considered in the differential diagnosis of cavernous sinus syndromes with neuro-ophthalmologic signs. For early diagnosis of neurosarcoidosis, it requires a high index of suspicion for searching sarcoidosis at sites outside the nervous system. Corticosteroid treatment is generally followed by improvement in clinical status, but there is a high rate of progression and recurrence after the treatment.
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PMID:Cavernous sinus syndrome due to sarcoidosis: a case report. 1953 74

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. 2, Ref. 60).
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PMID:Clinical manifestations of neurosarcoidosis. 1982 43

Sarcoidosis is a systemic disease characterised by non-caseating granulomas affecting mainly the lung and lymphatics. Literature reveals that 5% of the patients of sarcoidosis have involvement of the nervous system. Various neurological complications of sarcoidosis commonly reported are cranial nerve palsies, aseptic meningitis, myelopathy and intracranial masses. We report unusual case of neurosarcoidosis who presented with combination of right-sided vision loss and complete ophthalmoplegia with extensive leptomeningitis. This patient was suffering from resistant diabetes which leads to therapeutic problems.
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PMID:A rare case of extensive leptomeningitis in neurosarcoidosis. 2304 50


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