Recurrent multiple eye muscle palsy as a first sign of sarcoidosis
Purpose: To report a case of (neuro)sarcoidosis presenting solely with recurrent cranial nerve palsies in a 57-year-old Caucasian femaleMethods: Case report with clinical imagingResults: A 57-year-old female first presented with a right sixth nerve palsy, which resolved spontaneously after 6 months....
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| Format: | Article |
| Language: | English |
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German Medical Science GMS Publishing House
2023-11-01
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| Series: | GMS Ophthalmology Cases |
| Subjects: | |
| Online Access: | http://www.egms.de/static/en/journals/oc/2023-13/oc000229.shtml |
| _version_ | 1797629434160742400 |
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| author | Deboutte, Isabel Godts, Daisy Van Lint, Michel |
| author_facet | Deboutte, Isabel Godts, Daisy Van Lint, Michel |
| author_sort | Deboutte, Isabel |
| collection | DOAJ |
| description | Purpose: To report a case of (neuro)sarcoidosis presenting solely with recurrent cranial nerve palsies in a 57-year-old Caucasian femaleMethods: Case report with clinical imagingResults: A 57-year-old female first presented with a right sixth nerve palsy, which resolved spontaneously after 6 months. Three years later she was diagnosed with a sixth nerve palsy in the fellow eye followed by a complete palsy of the left third cranial nerve four months after. Medical history consisted of migraine and hypercholesterolemia. Further neurological and ophthalmic work-up was unrevealing at first. After repeated magnetic resonance imaging, an enhancing lesion in the left cavernous sinus was seen, which was initially diagnosed as a meningioma. However, imaging of the chest revealed an image of sarcoidosis, and the lesion and ophthalmoplegia of the left eye disappeared with systemic corticosteroid treatment.Discussion: Sarcoidosis is the ultimate imitator and the possibility of neurosarcoidosis must be taken into account when presented with unexplained ophthalmoplegia. Neurosarcoidosis has imaging properties very similar to other diseases such as a meningioma, and misdiagnosis occurs easily. Spontaneous recovery of ophthalmoplegia can rarely occur in neurosarcoidosis. |
| first_indexed | 2024-03-11T10:54:18Z |
| format | Article |
| id | doaj.art-8d6ed18084d3463b995690f184071003 |
| institution | Directory Open Access Journal |
| issn | 2193-1496 |
| language | English |
| last_indexed | 2024-03-11T10:54:18Z |
| publishDate | 2023-11-01 |
| publisher | German Medical Science GMS Publishing House |
| record_format | Article |
| series | GMS Ophthalmology Cases |
| spelling | doaj.art-8d6ed18084d3463b995690f1840710032023-11-13T12:04:36ZengGerman Medical Science GMS Publishing HouseGMS Ophthalmology Cases2193-14962023-11-0113Doc2110.3205/oc000229Recurrent multiple eye muscle palsy as a first sign of sarcoidosisDeboutte, Isabel0Godts, Daisy1Van Lint, Michel2Department of Ophthalmology, Antwerp University Hospital, Edegem, BelgiumDepartment of Ophthalmology, Antwerp University Hospital, Edegem, BelgiumDepartment of Ophthalmology, Antwerp University Hospital, Edegem, BelgiumPurpose: To report a case of (neuro)sarcoidosis presenting solely with recurrent cranial nerve palsies in a 57-year-old Caucasian femaleMethods: Case report with clinical imagingResults: A 57-year-old female first presented with a right sixth nerve palsy, which resolved spontaneously after 6 months. Three years later she was diagnosed with a sixth nerve palsy in the fellow eye followed by a complete palsy of the left third cranial nerve four months after. Medical history consisted of migraine and hypercholesterolemia. Further neurological and ophthalmic work-up was unrevealing at first. After repeated magnetic resonance imaging, an enhancing lesion in the left cavernous sinus was seen, which was initially diagnosed as a meningioma. However, imaging of the chest revealed an image of sarcoidosis, and the lesion and ophthalmoplegia of the left eye disappeared with systemic corticosteroid treatment.Discussion: Sarcoidosis is the ultimate imitator and the possibility of neurosarcoidosis must be taken into account when presented with unexplained ophthalmoplegia. Neurosarcoidosis has imaging properties very similar to other diseases such as a meningioma, and misdiagnosis occurs easily. Spontaneous recovery of ophthalmoplegia can rarely occur in neurosarcoidosis.http://www.egms.de/static/en/journals/oc/2023-13/oc000229.shtmlsarcoidosisneurosarcoidosiseye muscle palsy |
| spellingShingle | Deboutte, Isabel Godts, Daisy Van Lint, Michel Recurrent multiple eye muscle palsy as a first sign of sarcoidosis GMS Ophthalmology Cases sarcoidosis neurosarcoidosis eye muscle palsy |
| title | Recurrent multiple eye muscle palsy as a first sign of sarcoidosis |
| title_full | Recurrent multiple eye muscle palsy as a first sign of sarcoidosis |
| title_fullStr | Recurrent multiple eye muscle palsy as a first sign of sarcoidosis |
| title_full_unstemmed | Recurrent multiple eye muscle palsy as a first sign of sarcoidosis |
| title_short | Recurrent multiple eye muscle palsy as a first sign of sarcoidosis |
| title_sort | recurrent multiple eye muscle palsy as a first sign of sarcoidosis |
| topic | sarcoidosis neurosarcoidosis eye muscle palsy |
| url | http://www.egms.de/static/en/journals/oc/2023-13/oc000229.shtml |
| work_keys_str_mv | AT deboutteisabel recurrentmultipleeyemusclepalsyasafirstsignofsarcoidosis AT godtsdaisy recurrentmultipleeyemusclepalsyasafirstsignofsarcoidosis AT vanlintmichel recurrentmultipleeyemusclepalsyasafirstsignofsarcoidosis |