Neuro-ophthalmic Manifestations of Meningocerebral Inflammation From the Limited Form of Wegener's Granulomatosis

Newman, Nancy J.; Slamovits, Thomas L.; Friedland, Shmuel; Wilson, W. Bruce

doi:10.1016/s0002-9394(14)72208-1

Cited by 66 publications

(38 citation statements)

References 26 publications

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“…The lesions found on CT were consistent with those previously reported in the literature [6][7][8][9]. Interestingly, an MRI scan 6 weeks before the patient died showed no contrast-enhanced lesions, although granulomas and vasculitis were observed on microscopy after death.…”

Section: Discussionsupporting

confidence: 89%

“…This patient exhibited seizures shortly after admission. While seizures have previously been described as the main presenting symptom, this is considered rare [6][7][8][9]. CNS involvement in WG is believed to occur through three different mechanisms: direct invasion of granulomas from the paranasal sinuses, remote granulomas in the meninges or cerebrum, and vasculitis [4].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Limited Wegener's granulomatosis with central nervous system involvement and fatal outcome

Nordmark¹,

Boquist²,

Rönnblom³

1997

Journal of Internal Medicine

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Nordmark G, Boquist L, Rönnblom L (Boden Hospital and University Hospital, Umeå, Sweden). Limited Wegener's granulomatosis with central nervous system involvement and fatal outcome (Case Report). J Intern Med 1997; 242: 433–36. A 74‐year‐old woman was admitted to the medical department with vertigo and confusion, and suffered seizures three days later. Clinical, radiological and histopathological examination revealed limited Wegener's granulomatosis (WG) with central nervous system (CNS) involvement. Initially she was treated successfully with prednisolone and cyclophosphamide, but she relapsed after 25 months and died four weeks later. Autopsy showed widespread granulomas with vasculitis in the cerebrum. These findings emphasize the importance of considering WG in CNS disease of unclear origin, and demonstrate the aggressive nature of the disease.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Limited Wegener's granulomatosis with central nervous system involvement and fatal outcome

Nordmark¹,

Boquist²,

Rönnblom³

1997

Journal of Internal Medicine

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“…Neuropathies of single or multiple cranial nerves have been found either concurrently with obvious vasculitic activity in other organs or as a seemingly isolated finding [9][10][11][12]. The latter has been referred to as nonsystemic vasculitic neuropathy (NSVN) in neurology [13].…”

Section: Patterns Of Vasculitic Neuropathymentioning

confidence: 99%

“…Neurologists have repeatedly acknowledged this diagnostic dilemma of isolated cranial neuropathies [12,13,17].…”

Section: ■ Cns Biopsymentioning

confidence: 99%

Cranial nerve palsy in Wegener’s granulomatosis – Lessons from clinical cases

et al. 2009

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The problem of diagnosing vasculitic neuropathy is discussed based on case reports of two patients with Wegener's granulomatosis. One patient developed de novo 6(th) nerve palsy as an isolated relapse manifestation and the second patient a sequence of multiple cranial nerve palsies. Brain imaging with CT and MRI and the laboratory provided no clues suggesting active vasculitis. However, in both patients the neuropathies fully recovered in response to standard induction protocols of vasculitis. In the absence of organ-specific proof of vasculitis, these treatment decisions were guided by the overall clinical presentations. Cranial neuropathy may be the first obvious vasculitic manifestation preceding other organ disease, and since single reliable tests for its diagnosis are lacking, a multidisciplinary approach is advocated here to detect vasculitic manifestations in other organs.

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“…Peripheral cranial nerves, especially the third, fifth, seventh, and eighth, account for about 50% of pachymeningitis cases (Anderson et al 1975;Newman et al 1995;Novack et al 2009;Frith 2010).…”

mentioning

confidence: 99%