Neurosarcoidosis

Posted by e-Medical PPT Wednesday, October 27, 2010
Neurosarcoidosis refers to sarcoidosis, a condition of unknown cause featuring granulomas in various tissues, involving the central nervous system.It can have many manifestations, but abnormalities of the cranial nerves are the most common. It may develop acutely, subacutely, and chronically. Approximately 5-10% of people with sarcoidosis of other organs (e.g. lung) develop central nervous system involvement. Only 1% of people with sarcoidosis will have neurosarcoidosis alone without involvement of any other organs.
Abnormalities of the cranial nerves are present 50-70% of cases.The most common abnormality is involvement of the facial nerve, which may lead to reduced power on one or both sides of the face, followed by reduction in visual perception due to optic nerve involvement. Rarer symptoms are double vision,decreased sensation of the face,hearing loss or vertigo, swallowing problems and weakness of the shoulder muscles or the tongue.Seizures (mostly of the tonic-clonic type) are present in about 15%.Meningitis occurs in 3-26% of cases. Symptoms may include headache and nuchal rigidity.
Other investigations that may be performed in any of the symptoms mentioned above are computed tomography (CT) or magnetic resonance imaging (MRI) of the brain, lumbar puncture, electroencephalography (EEG) and evoked potential (EP) studies. If the diagnosis of sarcoidosis is suspected, typical X-ray or CT appearances of the chest may make the diagnosis more likely; elevations in angiotensin-converting enzyme and calcium in the blood, too, make sarcoidosis more likely.Treatment is with immunosuppression.

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