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Diagnosis and Management of Neurological Sarcoidosis
Arch Int Med 157:1864-1868, Lower,E.E.,et al, 1997
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Article Abstract
Neurological disease was identified in 71 of 554 patients with sarcoidosis.Seventh(facial)cranial nerve paralysis was the most common manifestation identified in 39 patients.This included 24 patients with facial nerve palsy as the only manifestation of neurological sarcoidosis in whom complete recovery was seen in all but 1 patient.Forty-eight patients with disease other than facial nerve palsy received corticosteroids or other therapies.Corticosteroids benefited only 14 patients(29%).Methotrexate successfully treated 17(61%)of 28 patients and cyclophosphamide controlled disease in 9(90%)of 10 assessable patients. Methotrexate and cyclophosphamide were each associated with a higher response rate than corticosteroids alone(x squared,14.6;P<.001). Neurological symptoms can be significantly manifestations of sarcoidosis. Facial nerve paralysis is a common,but usually self-limited form of disease.Other manifestations are usually chronic and agents other than corticosteroids appear to have increased efficacy with lower morbidity.
 
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cyclophosphamide
facial nerve palsy
immunosuppressive agents
methotrexate
neurologic disease,diagnoses of
prognosis
review article
sarcoidosis
sarcoidosis,CNS
steroid therapy,CNS treatment and complications with
treatment of neurologic disorder

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