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A Case of Probable Neurosarcoidosis Presenting as Unilateral Ophthalmoplegia

Mirjana Jovićević ; Clinical Department of Neurology, Clinical Center of Vojvodina, Novi Sad, Serbia
Marija Žarkov ; Clinical Department of Neurology, Clinical Center of Vojvodina, Novi Sad, Serbia
Tamara Rabi Žikić ; Clinical Department of Neurology, Clinical Center of Vojvodina, Novi Sad, Serbia
Duško Kozić ; Diagnostic Imaging Center, Oncology Institute of Vojvodina, Serbia
Sonja Rajić ; Clinical Department of Neurology, Emergency Center, Clinical Center of Vojvodina, Novi Sad, Serbia
Dušica Simić Panić ; Department for Medical Rehabilitation, Clinical Center of Vojvodina; Novi Sad, Serbia; , Medical Faculty, University of Novi Sad, Novi Sad, Serbia


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Abstract

Sarcoidosis is a multisystem disease of unknown etiology, characterized by the presence of noncaseating epithelioid granulomas and accumulation of T lymphocytes and mononuclear phagocytes, which damages the normal structure of tissues. Isolated form of neurosarcoidosis is very rare and difficult to diagnose and requires histologic confirmation of noncaseating granulomas in the nervous tissue. We report a case of a 55-year-old female who had probable isolated neurosarcoidosis based on magnetic resonance imaging findings of relapsing pachymeningitis with an inflammatory process in the apex of the right orbit and pseudotumor inflammation of the superior and lateral recti of the right eye. Diagnosis was further verified by positive response to dual corticosteroid and immunosuppressive therapy. Our case demonstrates the importance of considering isolated neurosarcoidosis as a potential underlying etiology of painful ophthalmoplegia, even without systemic manifestation of the disease.

Keywords

Neurosarcoidosis – diagnosis; Ophthalmoplegia; Magnetic resonance imaging; Central nervous system diseases; Case reports

Hrčak ID:

148940

URI

https://hrcak.srce.hr/148940

Publication date:

1.11.2015.

Article data in other languages: croatian

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