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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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