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MRI brain images demonstrating multiple cranial nerve thickening and enhancement Axial post-contrast MRI sequences depicting thickening and enhancement of the (A) bilateral optic tracts, (B) right trigeminal nerve, (C) left trigeminal nerve, (D) bilateral abducens nerves and right facial nerve, (E) left hypoglossal nerve, (F) right optic nerve, (G) infundibulum, and (H) left trochlear nerve.
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Here, we report a case of Burkitt's lymphoma in an HIV-positive patient presenting with features suggestive of Vogt-Koyanagi-Harada disease (VKHD), which in retrospect was likely a misdiagnosis. We hope to describe a rare presentation of lymphoma in order to prevent misdiagnosis and promote early recognition. The patient was a 25-year-old male who...
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Context 1
... two days later, he was run as a stroke code with emergent imaging for new-onset tongue deviation, slurred speech, and diminished hearing in his right ear. MRI brain with and without contrast noted extensive cranial nerve thickening and enhancement, including bilateral cranial nerves II and III, left cranial nerve IV, bilateral cranial nerve V, left cranial nerve VI, right greater than left cranial nerve VII and VIII, and left cranial nerve XII ( Figures 1A-1H). Differential diagnosis at this time included progression of VKHD, infectious or inflammatory granulomatous processes, neoplastic involvement, or an idiopathic inflammatory polyneuropathy with cranial nerve involvement such as Miller Fisher variant versus a hereditary polyneuropathy or neurofibromatosis. ...
