Neurosarcoidosis directly involving the cervical vagus nerve
JR Crossley, N Aminpour… - Annals of Otology …, 2021 - journals.sagepub.com
Annals of Otology, Rhinology & Laryngology, 2021•journals.sagepub.com
Objectives: To present a novel location in which neurosarcoidomatous inflammation is
identified and its accompanying presentation. Methods: The authors present a case of
bilateral vocal fold paresis associated with non-caseating granulomatous inflammation of
the cervical and intra-axial portions of the vagus nerve masquerading as a cranial nerve
tumor. Results: Examination revealed bilateral vocal fold paresis and asymmetric palate
elevation. MRI demonstrated enhancing bilateral jugular foramen masses, and neck …
identified and its accompanying presentation. Methods: The authors present a case of
bilateral vocal fold paresis associated with non-caseating granulomatous inflammation of
the cervical and intra-axial portions of the vagus nerve masquerading as a cranial nerve
tumor. Results: Examination revealed bilateral vocal fold paresis and asymmetric palate
elevation. MRI demonstrated enhancing bilateral jugular foramen masses, and neck …
Objectives
To present a novel location in which neurosarcoidomatous inflammation is identified and its accompanying presentation.
Methods
The authors present a case of bilateral vocal fold paresis associated with non-caseating granulomatous inflammation of the cervical and intra-axial portions of the vagus nerve masquerading as a cranial nerve tumor.
Results
Examination revealed bilateral vocal fold paresis and asymmetric palate elevation. MRI demonstrated enhancing bilateral jugular foramen masses, and neck ultrasound demonstrated bilateral thickened appearance of the vagus nerves. Vagus nerve biopsy demonstrated non-caseating granulomas.
Conclusions
Neurosarcoidosis may contribute to variable cranial neuropathies. Vocal fold paresis is usually thought to arise from mediastinal compression of the left recurrent laryngeal nerve. Rarely, though, lesions may arise in other parts of the vagus nerve. Failure of response to steroids does not rule out the diagnosis, making tissue diagnosis important in some cases.
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