English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Plus monthly

Global: Zendy Tools annual

Global: Zendy Tools monthly

Global: Zendy Free Plan

Case description: A 38-year-old Caucasian man presented with a three month history of headache and a ten day history of confusion and abnormal movements in the right upper extremity. The patient did not have any other systemic symptoms such as visual disturbances, arthritis, oral or genital ulcers, dry eyes or dry skin, but reported a history of weight loss, night sweats as well. MR brain showed extensive white matter disease with deep grey matter involvement, linear perivascular enhancement and deep medullary venous engorgement, suggesting deep vein thrombosis. Cerebrospinal fluid (CSF) labs revealed a leukocytosis of 98/ul, glucose of 39 mg/dl, and protein of 413 mg/dl. CSF angiotensin converting enzyme (ACE) positive at 4 U/L. The infectious and rheumatological workup were negative including fungal cultures, MTB PCR, Quant Gold test, ANA, Anti SSA, SSB, ANCA, HIV, HBV. Computed tomography (CT) chest showed pulmonary granulomatous disease and calcified hilar lymphadenopathy. Meningeal biopsy was negative for granulomas. After considering and ruling out conditions such as Behcet’s disease, Sjogren’s, vasculitis, and CNS lymphoma. Our patient fitted into ‘possible’ neurosarcoidosis due to a lack of pathological confirmation of granulomatous disease.

An Atypical Presentation of ‘Possible’ Neurosarcoidosis: A Stepwise Approach to a Case with Review of Literature