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• Vol.45 No.1
• CLINICA NEUROL, 45: 38−40, 2005
• Vol.45 No.1 contents

Brief Clinical Note

Abducens nerve palsy as the first manifestation of cavernous sinus sarcoidosis

Hikaru Nagasawa, M.D., Chibumi Iseki, M.D., Manabu Wada, M.D., Keiji Kurita, M.D. and Takeo Kato, M.D.

The Third Department of Internal Medicine, Yamagata University School of Medicine

We report a 33-year-old man who presented with an acute onset of diplopia and orbitalgia. Neurological examination revealed right abducent nerve palsy. Brain MRI showed a gadolinium-enhancing mass lesion in the right cavernous sinus. Chest CT showed a small lymph node swelling in the subcarinal compartment. Serum angiotensin converting enzyme and lysozyme levels were within normal range. Biopsied lymph node in the left supraclavicular fossa showed non-caseating epitheloid granulomas, consistent with sarcoidosis. After oral administration of predonisolone, his right abducent nerve palsy ameliorated in a few days and completely disappeared by 6 weeks after treatment. Abducent nerve palsy can be the first clinical manifestation of cavernous sinus sarcoidosis.

(CLINICA NEUROL, 45: 38−40, 2005)
key words: cavernous sinus syndrome, sarcoidosis, abducens nerve palsy, ophthalmoplegia

(Received: 16-Feb-04)