Rinsho Shinkeigaku (Clinical Neurology)

Case Report

A patient with neurosarcoidosis presenting with easy falling and dysphagia

Madoka Okamura, M.D., Ph.D.1), Mai Hamaguchi, M.D.1), Keisuke Suzuki, M.D., Ph.D.1), Toshiki Nakamura, M.D., Ph.D.2), Hiroaki Fujita, M.D., Ph.D.1) and Koichi Hirata, M.D., Ph.D.1)

1)Department of Neurology, Dokkyo Medical University
2)Department of Neurology, Rehabilitation Amakusa Hospital

A 68-year-old woman was referred to our hospital for progressive dizziness, gait disturbances and weight loss for 18 months. The patient was alert and showed dysphagia and a marked tendency to fall backward. Electronystagmography showed bilateral vestibular dysfunction and audiometry showed right sensorineural hearing disturbance. Cerebrospinal fluid exam showed mononuclear pleocytosis and elevated protein levels. On 18F-FDG PET/CT, abnormal uptake was observed in the mediastinal lymph nodes, from which biopsy specimens were obtained. Histological findings showed non-caseous granuloma and a diagnosis of bilateral vestibulocochlear, glossopharyngeal and vagal nerve palsies due to neurosarcoidosis was made. Steroid therapy resulted in improvement in her clinical symptoms. Neurosarcoidosis should be included in the differential diagnosis of patients showing progressive easy falling and dysphagia.
Full Text of this Article in Japanese PDF (447K)

(CLINICA NEUROL, 60: 346|350, 2020)
key words: bilateral vestibulopathy, neurosarcoidosis, easy falling, dysphagia

(Received: 18-Dec-19)