Chest
ReviewsNeurosarcoidosis: A Personal Perspective Based on the Study of 37 Patients
Section snippets
Clinical Material
Between January 1965 and December 1995, 37 patients, principally at Los Angeles County-University of Southern California Medical Center and University of Southern California-University Hospital, both in Los Angeles, presented with neurosarcoidosis. These patients had clinical and histologic evidence of multisystem sarcoidosis. In addition to neurologic involvement, there was evidence of intrathoracic involvement in 29 (78%) patients, ocular disease in eight (22%), cutaneous sarcoidosis in five
Discussion
The diagnosis of neurosarcoidosis requires a compatible clinical or radiologic picture of sarcoidosis and histologic confirmation of noncaseating granulomas or a positive Kveim-Stilzbach test. The presence of one without the other may lead to misdiagnosis. Although the chest radiograph is abnormal in >90% of patients with sarcoidosis and is the first tool of diagnostic investigation when sarcoidosis is considered, in this study, the chest radiograph was abnormal in only 78% of the patients. In
Conclusion
Based on the analysis of 37 cases of neurosarcoidosis, the following caveats are appropriately pragmatic and useful.
(1) Any part of the CNS may be affected by sarcoidosis. (2) When the nervous system lesions occur in the absence of other tissue involvement, the diagnostic process is arduous. (3) Serum and CSF ACE levels,67 gallium scanning, CT, MRI, position imaging tomography, visual and auditory evoked potentials, and BAL may all be helpful, but in selected cases in which the possibility of
References (37)
- et al.
Vocal cord paralysis as the presenting symptom of sarcoidosis
Respir Med
(1994) - et al.
Bilateral optic neuropathy as the initial manifestation of systemic sarcoidosis
Am J Ophthalmol
(1993) - et al.
Subdural mass lesion secondary to sarcoid granuloma: MR and CT findings and differential diagnosis
Comput Med Imaging Graph
(1989) - et al.
Cerebrospinal fluid lysozyme and ß2-microglobulin in neurosarcoidosis
J Neurol Sci
(1986) Neurosarcoidosis
Neurosarcoidosis: progress and clinical aspects
Neurology
(1993)Neurologic manifestations in sarcoidosis: a review of literature with a report of 23 cases
Ann Intern Med
(1977)- et al.
Neurosarcoidosis
Proc R Soc Med
(1967) - et al.
Neurosarcoidosis: a report of 14 cases
Sarcoidosis
(1994) Sarcoidosis with involvement of the nervous system
Brain
(1948)
The natural history of neurosarcoidosis
Proc R Soc Med
Sarcoidosis of the nervous system
J Neurol Neurosurg Psychiatry
Optic nerve granuloma as a first sign of sarcoidosis
Opthalmologica
Sarcoidosis presenting as multiple cranial neuropathies and a parotid mass
Otolaryngol Head Neck Surg
Recurrent layngeal palsy and mediastinal lymphodenopathy
Respir Med
Sarcoidosis involving the optic nerve and hypothalamus
Arch Ophthalmol
Neurosarcoidosis: signs, course and treatment in 35 confirmed cases
Medicine
Radiological findings in sarcoidosis
Br J Radiol
Cited by (0)
revision accepted December 11.