Tinnitus as a presenting symptom of neurosarcoidosis with ocular involvement.
BMJ Case Rep
; 14(5)2021 May 24.
Article
in En
| MEDLINE
| ID: mdl-34031071
ABSTRACT
A 48-year-old woman with untreated hypothyroidism initially presented with tinnitus and hearing loss, followed by blurred vision and eye pain months later. Ophthalmic evaluation revealed no optic disc oedema. Visual field defects in both eyes suggested retrobulbar optic neuropathy. MRI of the brain and orbits demonstrated enhancement of both optic nerve sheaths and diffuse pachymeningeal enhancement. Audiologic evaluation revealed hearing loss in both ears, and frequent square wave jerks were seen on videonystagmography. Fine needle aspiration from one pulmonary lymph node showed non-necrotising granulomatous inflammation, confirming the diagnosis of neurosarcoidosis. The visual fields improved significantly on prednisone, and she is maintained on prednisone, infliximab and methotrexate. Though common, multiple cranial neuropathies in neurosarcoidosis are poorly represented in the literature. Clinicians should be aware of the symptoms that may herald a diagnosis of neurosarcoidosis, so that treatment may be implemented sooner, and further cranial neuropathies may be prevented.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Sarcoidosis
/
Tinnitus
/
Central Nervous System Diseases
Type of study:
Diagnostic_studies
/
Etiology_studies
Limits:
Female
/
Humans
/
Middle aged
Language:
En
Journal:
BMJ Case Rep
Year:
2021
Document type:
Article
Affiliation country: