Uzawa Akiyuki, Kojima Shigeyuki, Yonezu Tadahiro, Kanesaka Toshihide
Department of Neurology, Matsudo Municipal Hospital, Chiba, Japan.
J Neurol Sci. 2009 Jun 15;281(1-2):108-9. doi: 10.1016/j.jns.2009.03.005. Epub 2009 Mar 31.
We report the case of a 43-year-old woman who developed multiple cranial nerve palsy, the symptoms of which included hyposmia, visual loss, facial hypoesthesia, facial weakness, dysphagia, gustatory disturbance, and sensory disturbance of the trunk and ulnar side of the bilateral arms. The clinical features included swelling of the bilateral hilar lymph nodes, uveitis, an elevated serum angiotensin-converting enzyme level, and negative tuberculin reactions, which led to a diagnosis of neurosarcoidosis. Her symptoms improved after administration of steroids. An elevated cerebrospinal fluid cell count and protein level, a low-frequency F-wave and slightly decreased sensory nerve action potentials in bilateral ulnar nerves by nerve conduction studies, and normal findings in the spine by magnetic resonance imaging suggested that truncal hypoesthesia was caused by polyradiculopathy. Although rare, in patients with neurosarcoidosis, truncal polyradiculopathy is noteworthy findings in addition to cranial nerve palsy.
我们报告了一例43岁女性患者,该患者出现了多发性脑神经麻痹,症状包括嗅觉减退、视力丧失、面部感觉减退、面部无力、吞咽困难、味觉障碍以及双侧手臂躯干和尺侧感觉障碍。临床特征包括双侧肺门淋巴结肿大、葡萄膜炎、血清血管紧张素转换酶水平升高以及结核菌素反应阴性,这些表现导致了神经结节病的诊断。使用类固醇治疗后,她的症状有所改善。脑脊液细胞计数和蛋白水平升高、神经传导研究显示双侧尺神经低频F波和感觉神经动作电位略有降低、磁共振成像显示脊柱无异常,提示躯干感觉减退是由多发性神经根病引起的。虽然罕见,但在神经结节病患者中,除了脑神经麻痹外,躯干多发性神经根病也是值得注意的表现。