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| Format: | Artículo científico |
| Language: | en |
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Associação Neurologia Cognitiva e do Comportamento
2013
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| Online Access: | https://www.redalyc.org/articulo.oa?id=339530369012 |
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Table of Contents:
- Rapidly progressive dementia due to neurosarcoidosis Gabriela Carneiro C. Fortes Marcos Castello B. Oliveira Laura Cardia G. Lopes Camila S. Tomikawa Leandro T. Lucato Luiz Henrique M. Castro Ricardo Nitrini Medicina neurosarcoidosis diencephalic amnesia primary CNS vasculitis rapidly progressive dementia Rapidly progressive dementia (RPD) is typically defined as a cognitive decline progressing to severe impairment in less than 1-2 years, typically within weeks or months. Accurate and prompt diagnosis is important because many conditions causing RPD are treatable. Neurosarcoidosis is often cited as an unusual reversible cause of RPD. Methods: We report two cases of neurosarcoidosis presenting as RPD. Results: Case 1: A 61-year-old woman developed a RPD associated with visual loss. In seven months she was dependent for self-care. Magnetic resonance imaging (MRI) revealed temporal and suprasellar brain lesions. Treatment with high-dose intravenous prednisolone was associated with partial improvement. Case 2: A 43-year-old woman who was being treated for diabetes insipidus developed a severe episodic amnesia one year after onset of cognitive symptoms. Previous MRI had shown a hypothalamic lesion and she had been treated with oral prednisone and cyclophosphamide. There was reduction of the MRI findings but no improvement in the cognitive deficits. Brain biopsy disclosed noncaseous granulomas and granulomatous angiitis; treatment was changed to high-dose intravenous methylprednisolone, with poor symptomatic response. Conclusion: The diagnosis of RPD due to neurosarcoidosis can be challenging when the disease is restricted to the nervous system. In these cases, clinical presentation of RPD associated with neuroendocrine and visual dysfunction, imaging findings showing hypothalamic lesions and, in some cases, brain biopsy, are the key to a correct diagnosis. It is possible that earlier diagnoses and treatment could have led to a better outcome in these patients 2013 artículo científico 1980-5764 https://www.redalyc.org/articulo.oa?id=339530369012 en http://www.redalyc.org/revista.oa?id=3395 Dementia & Neuropsychologia application/pdf Associação Neurologia Cognitiva e do Comportamento Dementia & Neuropsychologia (Brasil) Num.4 Vol.7