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Neuroimaging was abnormal in all patients when contrast was used; meningeal enhancement was the most common finding. Spinal fluid was abnormal in 95% of patients. Seventy percent of chest x-rays and 80% of chest CT scans performed at the time of presentation were abnormal. All 12 gallium scans that w4ere performed were abnormal. Diagnosis was confirmed by biopsy of neural tissue in 36% and of non-neural tissue in 64%. Initial response to oral corticosteroids was favorable, but more than half of the patients at 1 year had deteriorated. The evaluation of patients with primary neurosarcoidosis can be optimized by combining clinical suspicion, based on presenting symptoms and signs, with spinal fluid and neuroimaging studies. Appropriate use of c hest x-ray and CT and gallium scans frequently leads to diagnosis from lymph node or lacrimal gland biopsy. |
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CAT scan,chest
cauda equina,enhancement
cerebrospinal fluid,abnormal
cerebrospinal fluid,elevated protein of
cerebrospinal fluid,oligoclonal IgG in
chest x-ray,abnormal
cranial nerve palsies
cranial neuropathy
encephalopathy
gallium scan
headache
hypoglycorrhachia
lacrimal gland
lymph node biopsy
MRI
MRI,abnormal
myelopathy
pleocytosis of cerebrospinal fluid
review article
sarcoidosis
sarcoidosis,CNS
seizure
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