1/3. Facial palsy in Heerfordt's syndrome: electrophysiological localization of the lesion.Heerfordt's syndrome is characterized by fever, uveitis, swelling of the parotid gland, and facial nerve palsy and represents a variety of neurosarcoidosis. Since the first description of the syndrome, discussion about the lesion site has been controversial and has included the assumption of direct nerve compression by parotid gland swelling or a lesion within the facial canal in light of observations of accompanying taste disturbance. We report on a 26-year-old man with typical Heerfordt's syndrome who developed bilateral facial nerve palsy. Electrical and magnetic stimulation of the whole facial motor path provided strong evidence for a pathological process that: (i) began in the cerebellopontine angle; (ii) spread distally into the facial canal; and (iii) could be characterized by proximal demyelination. The patient recovered completely within 6 weeks under immunosuppressive therapy with steroids.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
2/3. diagnosis of Heerfordt's syndrome by state-of-the-art ultrasound in combination with parotid biopsy: a case report.The parotid gland is rarely affected by sarcoidosis (6% of all cases). If there is initial parotitis, and other major symptoms include fever, uveitis, or facial paralysis, the condition is referred to as Heerfordt's syndrome. The case presented here describes the diagnostic work-up and differentiation of swelling of the parotid gland by employing state-of-the-art ultrasound techniques in a 33-year-old patient with Heerfordt's syndrome. color-coded duplex ultrasound demonstrated hypervascularization. Tissue harmonic and photopic imaging ultrasound additionally depicted hypoechoic, septated structural lesions of the glandular parenchyma with an optimized contrast. Since such structural changes are not a specific sonographic criterion for sarcoidosis, ultrasound-guided biopsy was performed for further clarification of the etiology of parotitis and for excluding lymphoma. In conclusion, state-of-the-art ultrasound with the option of obtaining a biopsy at low risk is a useful procedure for diagnosing unclear pathology of the parotid gland with rapid histological confirmation.- - - - - - - - - - ranking = 2keywords = gland (Clic here for more details about this article) |
3/3. diagnosis of uveo-parotid fever by 67Ga-citrate imaging.67Ga-citrate scan from skull to mid-abdomen showed increased uptake in both parotid glands, mediastinum, lungs, uvei and/or enlarged lacrimal glands. The differential diagnosis of the positive radiogallium scan is discussed with emphasis on the value of the extrathoracic findings. Tissue diagnosis confirmed the imaging diagnosis of sarcoidosis. The case illustrates the usefulness of double radionuclide study--67Ga and 99mTc-MAA--and of the tomographic scanner in defining the spread of the active granulomatous disease.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |