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Neurological Sciences

, Volume 38, Issue 3, pp 517–519 | Cite as

Cavernous sinus syndrome due to neurosarcoidosis in adolescence: a diagnosis not to be missed

  • F. Rosini
  • D. Bennett
  • A. Cerase
  • L. Volterrani
  • A. Federico
  • P. Rottoli
  • Alessandra Rufa
Letter to the Editor

Dear Sir,

Cavernous sinus syndrome (CSS) is a pathological condition characterized by usually unilateral painful ophthalmoplegia associated with headache, diplopia, ptosis, pupillary changes, trigeminal nerve dysfunction and retro-orbital pain. Primitive or metastatic malignancies, vascular abnormalities and inflammatory processes are the most common causes of CSS [1]. Differential diagnosis between the various conditions may be tangled; in this respect, laboratory and brain MRI findings are discriminatory [2]. We describe here a rare case of unilateral CSS as the presenting sign of neurosarcoidosis in adolescence.

A 16-year-old female referred to our neuro-ophthalmological outpatient service for right ptosis, non-reacting midriasis, pain during eye movements, cephalalgia, and diplopia. She also referred mild exertional dyspnea and fatigue in the last months. Neurological and neuro-ophthalmological examinations showed complete right III cranial nerve palsy with non-reacting midriasis,...

Keywords

Sarcoidosis Cranial Nerve Palsy Painful Ophthalmoplegia Cavernous Sinus Syndrome Chitotriosidase Level 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgements

We gratefully thank Dr. Q. Marignetti, from the Radiology Unit of Valdichiana Hospital of Nottola, and I. Giani, from Pediatrics Unit of Valdichiana Hospital of Nottola, for their precious help.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest. Anonymity of patient was protected in this case report.

References

  1. 1.
    Lee JH, Lee HK, Park JK, Choi CG, Suh DC (2003) Cavernous sinus syndrome: clinical features and differential diagnosis with MR imaging. AJR Am J Roentgenol 181:583–590CrossRefPubMedGoogle Scholar
  2. 2.
    Fernández S, Godino O, Martínez-Yélamos S, Mesa E, Arruga J, Ramón JM, Acebes JJ, Rubio F (2007) Cavernous sinus syndrome: a series of 126 patients. Medicine (Baltimore) 86:278–281CrossRefGoogle Scholar
  3. 3.
    Bargagli E, Bennett D, Maggiorelli C, Di Sipio P, Margollicci M, Bianchi N, Rottoli P (2013) Human Chitotriosidase: a sensitive biomarker of sarcoidosis. J Clin Immunol 33:264–270CrossRefPubMedGoogle Scholar
  4. 4.
    Hebel R, Dubaniewicz-Wybieralska M, Dubaniewicz A (2015) Overview of neurosarcoidosis: recent advances. J Neurol 262:258–267CrossRefPubMedGoogle Scholar
  5. 5.
    Chang CS, Chen WL, Li CT, Wang PY (2009) Cavernous sinus syndrome due to sarcoidosis: a case report. Acta Neurol Taiwan 18:37–41PubMedGoogle Scholar

Copyright information

© Springer-Verlag Italia 2016

Authors and Affiliations

  • F. Rosini
    • 1
  • D. Bennett
    • 2
  • A. Cerase
    • 3
  • L. Volterrani
    • 4
  • A. Federico
    • 1
  • P. Rottoli
    • 2
  • Alessandra Rufa
    • 1
  1. 1.Clinical Neurology and Neurometabolic Diseases Unit, Department of Medical, Surgical and Neurological SciencesUniversity of SienaSienaItaly
  2. 2.Respiratory Diseases and Lung Transplant Unit, Department of Medical, Surgical and Neurological SciencesUniversity of SienaSienaItaly
  3. 3.Neuroimaging and Neurointervention UnitNINT, AOUSeneseSienaItaly
  4. 4.Department of Medical, Surgical and Neurological Sciences, Diagnostic ImagingUniversity of SienaSienaItaly

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