Open AccessPrimary Sjögren′s syndrome manifesting as multiple cranial neuropathies: MRI findings
Author(s) -
VV Ashraf,
Ramesh Bhasi,
R Praveen Kumar,
A S Girija
Publication year - 2009
Publication title -
annals of indian academy of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.427
H-Index - 31
eISSN - 1998-3549
pISSN - 0972-2327
DOI - 10.4103/0972-2327.53083
Subject(s) - medicine , hypophysitis , cranial nerves , magnetic resonance imaging , cranial nerve disease , lymphocytic infiltration , palsy , pathology , differential diagnosis , salivary gland , facial nerve , pituitary gland , surgery , eye disease , radiology , alternative medicine , hormone
We report a case of primary Sjögren's syndrome presenting with multiple cranial nerve palsies and radiological evidence of cranial pachymeningitis and hypophysitis. A 47-year-old woman developed right sensory neural hearing loss followed, 2 months later, by right facial palsy. Cranial magnetic resonance imaging showed features of pachymeningitis and pituitary gland infiltration. The diagnosis of primary Sjögren's syndrome was confirmed by demonstrating positive SS-A and SS-B antibodies and histological evidence of lymphocytic infiltration of the sublabial salivary gland. During the 2-year follow-up, the patient had transient VI(th), IX(th), X(th), and XII(th) cranial nerve palsies. Sjögren's syndrome should be considered in the differential diagnosis of patients presenting with multiple recurrent cranial nerve palsies, even if prominent sicca symptoms are absent.