A 30-year male with cognitive decline and unsteady gait

Teaching NeuroImages

NeurologyResident and Fellow Section

© 2013 American Academy of Neurology

Vignette

• A 30-year old male with history of bipolar disease presented with 6 months of cognitive decline, unsteady gait, urinary retention, and bilateral upper extremity tremors

Ramanathan et al.

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Ramanathan et al.

Diffuse Cerebral Neurosarcoidosis mimicking Gliomatosis Cerebri

• Neurosarcoidosis can mimic infection (viral, tuberculosis, or cryptococcus), toxic leukoencephalopathy & malignancies like gliomatosis cerebri or angiocentric lymphoma.

• MRI in neurosarcoidosis often reveals enhancing periventricular white matter lesions, in this case mimicking diffuse gliomatosis cerebri1,2.

• The patient responded well to high dose steroids and intravenous cyclophosphamide.

Ramanathan et al