Archive for the ‘Neurosarcoidosis’ Category


Neurosarcoidosis Associated with Hypersomnolence Treated with Corticosteroids and Brain Irradiation: DiscussionAlthough the pathogenesis of narcolepsy in our patient is obscure, recent evidence suggests several possible mechanisms. Sarcoid involvement of the hypothalamus may cause neuronal dysfunction with disruption of the usual non-REM-REM pattern of sleep. This may be due to the granulomatous involvement of the hypothalamus, as often observed at autopsies, or alternatively to granulomatous disruption of brain stem projections to higher regions or dysfunction of diencephalic centers. Rapid resolution of the narcoleptic features in response to prednisone therapy and brain irradiation may indirectly support this hypothesis. (more…)

  • Comments Off on Neurosarcoidosis Associated with Hypersomnolence Treated with Corticosteroids and Brain Irradiation: Discussion
  • Over the next several months, the patient developed severe steroid-induced side effects, including hypertension, carbohydrate intolerance, repeated GI bleeding, osteoporosis with multiple pathologic fractures, bilateral cataracts, and herpes zoster infection of the right ophthalmic division of the trigeminal nerve with ocular involvement and loss of vision in this eye. Because of the severity of the side effects, the dose of prednisone was tapered. However, his initial symptoms reappeared; cauda equina syndrome also developed. Myelogram revealed a large number of small filling defects scattered throughout the spinal subarachnoid space. Contrast-enhanced CT scan of the head showed an 8-mm round area of contrast enhancement located in the hypothalamus. The prednisone dose was increased to 40 mg daily.
    (more…)

  • Comments Off on Neurosarcoidosis Associated with Hypersomnolence Treated with Corticosteroids and Brain Irradiation: Case Report
  • Neurosarcoidosis Associated with Hypersomnolence Treated with Corticosteroids and Brain IrradiationCentral nervous system (CNS) involvement in sarcoidosis is well-known. In addition, sarcoidosis may produce psychiatric illness and short-term memory deficits. However, narcolepsy as a feature of CNS sarcoidosis has never been described to our knowledge. We describe a patient with neurosarcoidosis who presented as having subacute dementia, and who developed laboratory-documented narcoleptic features during the course of the follow-up. This was associated with a hypothalamic nodule demonstrated on the contrast-enhanced CT scan of the head. Combined corticosteroid therapy and cranial irradiation resulted in a complete resolution of his symptoms. (more…)

  • Comments Off on Neurosarcoidosis Associated with Hypersomnolence Treated with Corticosteroids and Brain Irradiation
  • Categories


    Advertising


    Most Popular

    • None found

    Recent Comments

    • None found