Alon Eran E, Ekbom Dale C
Dept of Otolaryngology-Head and Neck Surgery, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
Ann Otol Rhinol Laryngol. 2010 Sep;119(9):641-5. doi: 10.1177/000348941011900913.
Our objective was to review patients who presented to our medical center with a diagnosis of neurosarcoidosis affecting the vagus nerve and to present symptoms, progression, treatments, and outcome.
We performed a chart review of patients who presented to our medical center in the past 10 years with a diagnosis of neurosarcoidosis specifically affecting cranial nerve X.
A chart review of 53 patients revealed only 4 with findings suggestive of vagal neurosarcoidosis. All were male and had a mean age of 50 years (range, 42 to 57 years) at presentation of symptoms. Two of the 4 patients presented initially with cough, 1 had recurrent syncope, and another presented with left facial pain. Vagus nerve involvement included vocal fold paresis or paralysis in all 4 patients, 2 of whom reported coughing with exposure to various odors and 2 of whom were found to have a unilateral palatal weakness. All but 1 had positive findings on magnetic resonance imaging of the head.
Neurosarcoidosis involving the vagus nerve is a rare finding, but should be considered in the differential diagnosis of vocal fold paresis or paralysis.
我们的目的是回顾那些到我们医疗中心就诊、被诊断为累及迷走神经的神经结节病患者，并阐述其症状、病情进展、治疗方法及预后情况。
我们对过去10年到我们医疗中心就诊、被诊断为特别累及第十对脑神经的神经结节病患者的病历进行了回顾。
对53例患者的病历回顾显示，只有4例有提示迷走神经结节病的表现。所有患者均为男性，出现症状时的平均年龄为50岁（范围42至57岁）。4例患者中有2例最初表现为咳嗽，1例有反复晕厥，另1例表现为左侧面部疼痛。迷走神经受累包括所有4例患者均有声带轻瘫或麻痹，其中2例报告在接触各种气味时咳嗽，2例被发现有单侧腭部无力。除1例患者外，其他所有患者头部磁共振成像均有阳性发现。
累及迷走神经的神经结节病是一种罕见的表现，但在声带轻瘫或麻痹的鉴别诊断中应予以考虑。
