Sarcoidosis With Involvement of the Nervous System

Facial Nerve Enhancement on Gadolinium-DTPA in a Case with Neurosarcoidosis.

“…Facial nerve palsy is the most commoncranial nerve disorder associated with neurosarcoidosis (1)(2)(3)(4)(5)(6)(7). In several previous studies, facial nerve palsy was reported in 49% to 67% cases ofneurosarcoidosis (1,3,8).…”

“…Approximately 5%of patients with this disease manifest nervous system involvement (1)(2)(3)(4)(5)(6)(7). Among them, hydrocephalus is reported in approximately 10%of the cases and is generally considered as one of the serious neurological complications (2,3).…”

“…Among them, hydrocephalus is reported in approximately 10%of the cases and is generally considered as one of the serious neurological complications (2,3). Although cranial nerve palsy is the most commonneurological complication, its mechanismremains unclear (1)(2)(3)(4)(5)(6)(7). In the majority of cases with neurological complications, other signs of extra-neural systemic involvement are also manifested such as the swelling of bilateral pulmonary hilar lymph nodes and/or parenchymal lung lesions as demonstrated by histopathology or imaging studies.…”

Neurological Sarcoidosis

“…In hindsight, the first historically described cases occurred early in the 20 th century, when unusual presentations of parotid enlargement, uveitis, and facial palsies were described (Heerfordt 1909). Years later facial palsy was documented in half of neurosarcoidosis patients (Colover 1948, Stern et al 1985, making it the most predominant clinical association. A third of these cases are bilateral (Colover 1948, Stern et al 1985, and those presentations or recurrent facial palsy in general should trigger a suspicion for a secondary cause of facial palsy, such as Lyme disease or neurosarcoidosis.…”

“…This is especially important because the presenting manifestations may be neurological in nearly 50% of these patients (Stern et al 1985). The first large review of the trends of clinical involvement of the nervous system in sarcoidosis was outlined over 60 years ago (Colover 1948). Subsequent reviews and case reports have built on that foundation.…”