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Tytuł pozycji:

Facial nerve palsy in neurosarcoidosis: clinical course, neuroinflammatory accompaniments, ancillary investigations, and response to treatment.

Tytuł:
Facial nerve palsy in neurosarcoidosis: clinical course, neuroinflammatory accompaniments, ancillary investigations, and response to treatment.
Autorzy:
Nwebube CO; Department of Neurology, Emory University School of Medicine, 12 Executive Park Drive NE, Atlanta, GA, 30329, USA.
Bou GA; Department of Neurology, Emory University School of Medicine, 12 Executive Park Drive NE, Atlanta, GA, 30329, USA.
Castilho AJ; Division of Neuroradiology, Department of Radiology, Emory University School of Medicine, Atlanta, GA, USA.
Hutto SK; Department of Neurology, Emory University School of Medicine, 12 Executive Park Drive NE, Atlanta, GA, 30329, USA. .
Źródło:
Journal of neurology [J Neurol] 2022 Oct; Vol. 269 (10), pp. 5328-5336. Date of Electronic Publication: 2022 May 18.
Typ publikacji:
Journal Article
Język:
English
Imprint Name(s):
Original Publication: Berlin ; New York, Springer-Verlag
MeSH Terms:
Bell Palsy*
Facial Nerve Diseases*/etiology
Facial Paralysis*/etiology
Sarcoidosis*/complications
Sarcoidosis*/diagnostic imaging
Central Nervous System Diseases ; Facial Nerve/diagnostic imaging ; Humans ; Retrospective Studies
References:
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Contributed Indexing:
Keywords: Bell’s palsy; Cranial neuropathy; Facial neuropathy; Neurosarcoidosis; Sarcoidosis
SCR Disease Name:
Neurosarcoidosis
Entry Date(s):
Date Created: 20220518 Date Completed: 20220914 Latest Revision: 20220914
Update Code:
20240105
DOI:
10.1007/s00415-022-11189-6
PMID:
35583659
Czasopismo naukowe
Background: Facial nerve palsy is a cardinal manifestation of neurosarcoidosis, but dedicated studies of this disease feature have not been conducted. We sought to clarify the impact of facial palsy on the diagnosis of neurosarcoidosis, its subsequent clinicoradiographic evolution, and eventual treatment decisions.
Methods: A single-center retrospective analysis of patients with neurosarcoidosis and facial palsy was conducted over the preceding 10 years (01/01/2011-08/12/2021).
Results: 23/218 (10.6%) patients with neurosarcoidosis developed facial neuropathy. It was the inaugural manifestation of neurosarcoidosis in 17/23 (73.9%) and presented in isolation of other neurologic deficits or extra-facial MRI abnormalities in 12/23 (52.2%). At onset, facial palsy was unilateral in 20/23 (87.0%), and multiple cranial neuropathies were seen in 8/23 (34.8%). Non-facial inflammatory MRI abnormalities were observed in 6/15 (40.0%) patients at onset with leptomeningitis being most common (5/15, 33.3%). 13/23 (56.5%) experienced a second attack of neurosarcoidosis at a median of 8 months, including 3/23 (13.0%) with recurrent facial palsies. In the 12 patients with isolated facial paresis at onset, 4/12 (33.3%) remained free of new deficits or neuroimaging abnormalities by last follow-up. 17/23 (73.9%) eventually required initiation of steroid-sparing immunosuppressants, almost all for development of non-facial disease. The final median House-Brackmann score was 1.
Conclusion: Facial neuropathy occurred less commonly than historically reported, and it often acts as a forerunner to systemic sarcoidosis and more widespread neurologic disease. Recurrent attacks of neurosarcoidosis occur early at high frequency following facial palsy. Recovery of facial nerve function is typically excellent.
(© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)

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