Nörosarkoidoz ve Parsiyel Motor Nöbet

Özet

Scientific BACKGROUND: Sarcoidosis is a multisystem involving inflammatory disorder. Although neurological involvement according to clinical criteria is present in 5-16% of cases, a study in autopsy series showed that clinical diagnosis is only made in half of patients with neurosarcoidosis. However, isolated neurological involvement is rare.

CASE: A 48-year-old woman with partial seizures of one-year duration admitted to our clinic with headache. Neurological examination at the time of admittance was normal, cranial MRI demonstrated that the lesion enlarged and an additional lesion located in mesencephalon was found. During follow-up since skin lesions and respiratory symptoms arose, she was diagnosed as possible neurosarcoidosis. High dose parenteral methylprednisolone resulted in significant improvement.

CONCLUSION: Headache is the most frequent symptom and cranial neuropathies are the most commonly encountered manifestation in neurosarcoidosis. Seizures are reported in 15% of cases throughout the course of the disease and in 10% of cases as presenting finding. In our patient, neurological involvement preceeded systemic findings and diagnosis was based on biopsy. Spontaneous recovery is possible, however, progression is reported in 30% of cases. Both clinical and radiological findings of our patient improved significantly after high dose steroids and this treatment was tolerated by patient.