頭位眩暈を呈した神経サルコイドーシスの1例

Malignant Paroxysmal Positional Vertigo Caused by Intracranial Neurosarcoidosis:A Care Report

　はじめに

　頭位眩暈を主訴に当科を受診し，右側頭葉腫瘍の診断のもとに開頭による腫瘍摘出術が行われ，摘出標本よりサルコイドーシスと診断がついた神経サルコイドーシスの1例を経験した。サルコイドーシスの発症時自覚症状としては，霧視，羞明などの眼症状が最も多く，次いで皮疹，咳，全身倦怠感，発熱の順であり，眩暈が初発症状である例は少ない^1）。本症例の病変部位と眩暈との関係について，考察を加え報告する。

In a patient with paroxysmal positional vertigo, head position testing with head hanging produced a severe vertigo and downbeat nystagmus. Cranial T2-enhanced magnetic resonance imaging showed ahigh intensity mass in the right temporal lobe, but not in the region of the cerebellum nor the floor of the fourth ventricle. Right temporal craniotomy was performed and the mass was removed. The mass was histologically diagnosed as neurosarcoidosis. Corticosteroid treatment was given after the sur-gery. The patient's positional vertigo was improved and downbeat nystagmus was disappeared within a few weeks. The correlation between neurosar-coidosis and paroxysmal positional vertigo was discussed.