Annals of Indian Academy of Neurology
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CASE REPORT
Year : 2009  |  Volume : 12  |  Issue : 2  |  Page : 124-126

Primary Sjögren's syndrome manifesting as multiple cranial neuropathies: MRI findings


1 Department of Neurology, Malabar Institute of Medical Sciences, Calicut - 673 016, Kerala, India
2 Department of Rheumatology, Malabar Institute of Medical Sciences, Calicut - 673 016, Kerala, India

Correspondence Address:
V V Ashraf
Department of Neurology, Malabar Institute of Medical Sciences, Calicut - 673 016, Kerala
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-2327.53083

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We report a case of primary Sjögren's syndrome presenting with multiple cranial nerve palsies and radiological evidence of cranial pachymeningitis and hypophysitis. A 47-year-old woman developed right sensory neural hearing loss followed, 2 months later, by right facial palsy. Cranial magnetic resonance imaging showed features of pachymeningitis and pituitary gland infiltration. The diagnosis of primary Sjögren's syndrome was confirmed by demonstrating positive SS-A and SS-B antibodies and histological evidence of lymphocytic infiltration of the sublabial salivary gland. During the 2-year follow-up, the patient had transient VI th , IX th , X th , and XII th cranial nerve palsies. Sjögren's syndrome should be considered in the differential diagnosis of patients presenting with multiple recurrent cranial nerve palsies, even if prominent sicca symptoms are absent.


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