Chronic facial pain and Meckel cave masses as the initial presentation of neurosarcoidosis: a case report.

Abstract

Sarcoidosis is a systemic inflammatory disease that can affect virtually every organ system, leading to a wide variety of clinical manifestations. Central nervous system involvement producing neurologic symptoms can occur in patients with sarcoidosis, yet rarely are these symptoms the initial manifestations of the disease. Here we present the case of a 38-year-old man who presented with a history of chronic facial pain, blurred vision, increased lacrimation, and periodontal abscesses. Physical examination revealed no evidence of infection or neoplasm. Magnetic resonance imaging revealed space-occupying lesions in Meckel cave bilaterally, with soft-tissue density extending into the left sphenoid and posterior ethmoid sinuses. Endoscopic biopsy of sinus mucosa demonstrated the presence of noncaseating granulomas and the absence of organisms, findings suggestive of neurosarcoidosis. The diagnosis was further supported by chest radiography, which demonstrated bilateral hilar adenopathy. The patient was treated with corticosteroids, and his facial pain improved markedly. In this article we discuss neurosarcoidosis and its manifestations, diagnosis, and clinical course.

• Authors: Graham M Strub, Jaime E Moore, Andrew T Huang, Aaron W Stevenson, Evan R Reiter
• Journal: Ear, nose, & throat journal (Ear Nose Throat J) Vol. 92 Issue 12 Pg. 558-65 (Dec 2013) ISSN: 1942-7522 [Electronic] United States
• PMID: 24366702 (Publication Type: Case Reports, Journal Article)

Chemical References

• Adrenal Cortex Hormones

Topics

• Adrenal Cortex Hormones (therapeutic use)
• Adult
• Central Nervous System Diseases (complications, diagnosis, drug therapy)
• Chronic Pain (etiology)
• Cranial Fossa, Posterior
• Facial Pain (etiology)
• Humans
• Magnetic Resonance Imaging
• Male
• Paresthesia (etiology)
• Sarcoidosis (complications, diagnosis, drug therapy)