[Abducens nerve palsy as the first manifestation of cavernous sinus sarcoidosis].
We report a 33-year-old man who presented with an acute onset of diplopia and orbitalgia. Neurological examination revealed right abducent nerve palsy. Brain MRI showed a gadolinium-enhancing mass lesion in the right cavernous sinus. Chest CT showed a small lymph node swelling in the subcarinal compartment. Serum angiotensin converting enzyme and lysozyme levels were within normal range. Biopsied lymph node in the left supraclavicular fossa showed non-caseating epitheloid granulomas, consistent with sarcoidosis. After oral administration of predonisolone, his right abducent nerve palsy ameliorated in a few days and completely disappeared by 6 weeks after treatment. Abducent nerve palsy can be the first clinical manifestation of cavernous sinus sarcoidosis.
Nagasawa
Hikaru
H
The Third Department of Internal Medicine, Yamagata University School of Medicine.
Iseki
Chibumi
C
Wada
Manabu
M
Kurita
Keiji
K
Kato
Takeo
T
D020434:Abducens Nerve Diseases / Q000188:drug therapy / Q000209:etiology*; D000328:Adult; D002426:Cavernous Sinus / Q000473:pathology*; D005682:Gadolinium; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009886:Ophthalmoplegia / Q000175:diagnosis; D011239:Prednisolone / Q000008:administration & dosage; D012507:Sarcoidosis / Q000175:diagnosis* / Q000188:drug therapy
D005938:Glucocorticoids; D011239:Prednisolone; D005682:Gadolinium