Cauda equina and conus medullaris syndrome in sarcoidosis

Neurologist. 2005 May;11(3):179-83. doi: 10.1097/01.nrl.0000159983.19068.21.

Abstract

Background: Neurosarcoidosis is a rare manifestation of sarcoidosis. Involvement of the nervous system in sarcoidosis can range from peripheral or cranial neuropathy to central nervous system disease. Cauda equina sarcoidosis is distinctly rare.

Review summary: The authors present a 58-year-old patient with systemic sarcoidosis who developed cauda equina and conus medullaris syndrome. Seventeen previous published cases of cauda equina sarcoidosis are reviewed. The history of systemic sarcoidosis, cerebrospinal fluid characteristics of lymphocytic pleocytosis with elevated protein, and evidence of acute denervation by needle electromyography are helpful in the diagnosis of this condition. Early diagnosis and treatment of cauda equina sarcoidosis usually provide a rapid recovery and yield a good prognosis.

Conclusion: Although rare, sarcoidosis should be considered in the differential diagnosis of cauda equina syndrome, particularly in patients with unclear etiology.

Publication types

  • Case Reports

MeSH terms

  • Anti-Inflammatory Agents / therapeutic use
  • Central Nervous System Diseases / cerebrospinal fluid
  • Central Nervous System Diseases / complications*
  • Central Nervous System Diseases / drug therapy
  • Electrodiagnosis
  • Electromyography
  • Female
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Methotrexate / therapeutic use
  • Middle Aged
  • Muscle Weakness / etiology
  • Neural Conduction / drug effects
  • Neurologic Examination
  • Polyradiculopathy / cerebrospinal fluid
  • Polyradiculopathy / drug therapy
  • Polyradiculopathy / etiology*
  • Prednisone / therapeutic use
  • Sarcoidosis / cerebrospinal fluid
  • Sarcoidosis / complications*
  • Sarcoidosis / drug therapy
  • Spinal Cord Compression / cerebrospinal fluid
  • Spinal Cord Compression / drug therapy
  • Spinal Cord Compression / etiology*

Substances

  • Anti-Inflammatory Agents
  • Immunosuppressive Agents
  • Prednisone
  • Methotrexate