Table of Contents
Washington University Experience | MISCELLANEOUS | Neurosarcoid - no PNS | 8A0 Case 8 History
Case 8 History ---- The patient is a 23 year old woman who noted acute onset of right eye pain, pupil dilatation and blurry/double vision, as well as right sided headache. Lumbar puncture showed pleocytosis with a white count of 56 (70% lymphocytes [T cells by flow cytometry] 11% neutrophils, 5% eosinophils), increased protein (74) and decreased glucose (20). Smears, cultures and PCR tests for organisms were negative. Magnetic resonance imaging (MRI) showed abnormal signal in the distal medulla and proximal cervical spinal cord, raising concern for subarachnoid pathology at the origin of the right third nerve. Computed tomography of the chest, abdomen and pelvis was unremarkable. Later MRI shows multiple enhancing supratentorial and infratentorial extra-axial lesions, as well as additional nodules in the right lateral ventricular wall and brainstem. Enhancement is also present along the entire course of right cranial nerve III. One 1.0 x 0.9 cm enhancing and a FLAIR hyperintense lesion encases the right middle cerebral artery.
