Orbital apex syndrome associated with diffuse hypertrophic pachymeningitis in isolated neurosarcoidosis

Abstract

A 43-year-old woman reported acute onset of right retroorbital headache followed by ptosis, paralysis of extraocular muscles, and subsequently amaurosis, characterizing an orbital apex syndrome 1 . Brain MRI showed diffuse pachymeningitis with leptomeningeal and parenchymatous involvement (Figure 1). CSF analysis was unremarkable. ACE and

Older Woman With Proptosis, Ptosis, and Blurred Vision

“…Isolated neurosarcoidosis and simultaneous orbital and intracranial involvement are rare features of this case. Of 11 cases of cavernous sinus involvement reported, only 2 had concurrent orbital inflammation …”

“…Of 11 cases of cavernous sinus involvement reported, only 2 had concurrent orbital inflammation. 8,9 Initial treatment typically consists of oral prednisone, 0.25 to 1 mg/kg/d. This patient's initial dose of 20 mg/d was subtherapeutic given her weight (97.5 kg).…”