Baroreceptor denervation presenting as part of a vagal mononeuropathy

A 48-year-old woman presented with a history of progressive cough, dysphoni a, dysphagia, and postural symptoms. Subsequent neurological investigations were consistent with a bilateral vagal mononeuropathy, and neurosarcoidosi s was diagnosed after scalene node biopsy. Autonomic investigations includi ng microneurography, neurohormones, and heart rate variability demonstrated arterial and cardiopulmonary baroreflex failure. In addition, parasympathe tic control of heart rate was absent and consistent with a bilateral, nonse lective lesion in the proximal vagus.