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Sarcoidosis presenting as progressive multifocal leukoencephalopathy in an apparently immunocompetent adult
Neurological involvement in sarcoidosis is termed as neurosarcoidosis. It usually leads to cranial neuropathies, although it can involve any part of the neuroaxis. Although sarcoidosis is a proinflammatory state, there is an associated anergic state demonstrable by a feeble tuberculin response. Lymphocytic sequestration in granulomas can be associated with peripheral CD4 lymphocytopenia (40% of patients with sarcoidosis) predisposing to opportunistic infections. Here we have described a young, otherwise immunocompetent male presenting with subacute onset right hemiparesis with motor aphasia, who was diagnosed to have progr...
Source: Journal of Neuroimmunology - September 15, 2023 Category: Allergy & Immunology Authors: Shiny Joy, Ayush Agarwal, Divyani Garg, Ajay Garg, Divya M. Radhakrishnan, Awadh K. Pandit, Achal Kumar Srivastava Tags: Short Communication Source Type: research

Neurosarcoidosis and Neurologic Complications of Sarcoidosis Treatment
Sarcoidosis is an immune-mediated multisystem granulomatous disorder. Neurosarcoidosis (NS) accounts for 5% to 35% of cases. The diagnostic evaluation of NS can be a clinical challenge. Gadolinium-enhanced magnetic resonance imaging (MRI) is the gold standard to evaluate central nervous system NS. In almost all cases treatment is warranted. Although glucocorticoids remain the first-line therapy in patients with sarcoidosis, in NS timely initiation of second- or third-line treatment is strongly recommended. Of these, tumor necrosis factor-alpha inhibitors are the most promising. However, the treatment itself may be responsi...
Source: Clinics in Chest Medicine - September 4, 2023 Category: Respiratory Medicine Authors: Mareye Voortman, Marjolein Drent, Barney J. Stern Source Type: research

FDG-PET/CT scan reveals rare neurosarcoidosis
An FDG-PET/CT scan and thyroid biopsy changed a patient's diagnosis from termina...Read more on AuntMinnie.comRelated Reading: Are PSMA-PET tracers equal in detecting prostate cancer? PET/CT scans predict CAR-T therapy response in lymphoma patients AI outperforms clinical scores in high-risk lymphoma patients PET/CT links stress and poor outcomes in cancer patients PET/CT improves survival outcomes in patients with HNSCC
Source: AuntMinnie.com Headlines - August 30, 2023 Category: Radiology Source Type: news

Differential Diagnosis of Tumor-like Brain Lesions
Purpose of Review Tumor-like brain lesions are rare and commonly suggest a neoplastic etiology. Failure to rapidly identify non-neoplastic causes can lead to increased morbidity and mortality. In this review, we describe 10 patients who presented with atypical, non-neoplastic tumor-like brain lesions in which brain biopsy was essential for a correct diagnosis and treatment. Recent Findings There has been increasing recognition of autoimmune conditions affecting the nervous system, and many of those diseases can cause tumor-like brain lesions. Currently available reports of non-neoplastic tumor-like brain lesions are scarc...
Source: Neurology Clinical Practice - August 30, 2023 Category: Neurology Authors: Perez Giraldo, G. S., Singer, L., Cao, T., Jamshidi, P., Dixit, K., Kontzialis, M., Castellani, R., Pytel, P., Anadani, N., Bevan, C. J., Grebenciucova, E., Balabanov, R., Cohen, B. A., Graham, E. L. Tags: All Imaging, Autoimmune diseases, Vasculitis, Fungal infections, All Demyelinating disease (CNS) Review Source Type: research

Tumefactive brain parenchymal neurosarcoidosis
ConclusionTumefactive brain parenchymal lesions are uncommon, usually affect the supratentorial brain along with leptomeningitis, and are refractory to initial treatments with a high risk of relapse. Significant sequelae were encountered despite a favorable median last mRS.
Source: Journal of Neurology - August 12, 2023 Category: Neurology Source Type: research

Case report: A disconjugate pattern in video head impulse testing hints toward a central cause of acute vertigo
In this report, we aimed to highlight the unusual case of a disconjugate VOR as a distinctive VHIT pattern hinting toward a central cause of acute vertigo that clinicians should be aware of.
Source: Frontiers in Neurology - July 27, 2023 Category: Neurology Source Type: research

Uveitis in the Setting of Co-Existing Systemic Sarcoidosis and Multiple Sclerosis
We report a case of intermediate uveitis in the setting of both systemic sarcoidosis and multiple sclerosis. A 68-year-old female was diagnosed with bilateral granulomatous intermediate uveitis and cystoid macular edema. Initial systemic work-up was unrevealing. The uveitis was treated successfully with local corticosteroid injections. Eighteen months after presentation, the patient developed new systemic symptoms. Additional testing revealed systemic lymphadenopathy, with biopsy showing non-caseating granulomas, leading to a diagnosis of sarcoidosis. However, MRI of the brain and spinal cord along with cerebrospinal fluid...
Source: Ocular Immunology and Inflammation - July 19, 2023 Category: Allergy & Immunology Authors: Ramya Gnanaraj Anna A Shah Alan G Palestine Amit K Reddy Source Type: research

Cerebral lesions sites in neurosarcoidosis: a lesion mapping study
ConclusionsThe VLSM analysis yielded significant associations in the bilateral frontal cortex, suggesting that leptomeningeal inflammatory disease with following cortical involvement is a quite specific feature in neurosarcoidosis. Lesion load was lower in neurosarcoidosis than in multiple sclerosis. However, no specific pattern of subcortical white matter lesions in neurosarcoidosis was revealed.
Source: Journal of Neurology - July 12, 2023 Category: Neurology Source Type: research

Brain imaging inspired by outer space
Pract Neurol. 2023 Jul 7:pn-2023-003787. doi: 10.1136/pn-2023-003787. Online ahead of print.ABSTRACTMedicine has many vividly named signs. We have compiled a list of radiological cerebral signs inspired by phenomena in outer space. These range from the well-known 'starry sky' appearance of neurocysticercosis or tuberculomas, to various lesser known signs including the 'starfield' pattern of fat embolism; 'sunburst' sign of meningiomas; 'eclipse' sign of neurosarcoidosis; 'comet tail' sign of cerebral metastases; 'Milk Way' sign of progressive multifocal leukoencephalopathy; 'satellite' and 'black hole' sign of intracranial...
Source: Practical Neurology - July 7, 2023 Category: Neurology Authors: Divyani Garg Ayush Agarwal Achal K Srivastava Ajay Garg Source Type: research