Focal neurological deficit with sudden onset as the first manifestation of sarcoidosis: a case report with MRI follow-up

Eur Neurol. 1991;31(6):376-9. doi: 10.1159/000116697.

Abstract

Stroke as a presenting manifestation of sarcoidosis has rarely been reported. This contrasts with the frequent anatomopathological findings of cerebrovascular involvement in neurosarcoidosis. We present a patient who developed acutely a right brachiofacial weakness and dysarthria. Pulmonary sarcoidosis was found. A brain CT and magnetic resonance imaging (MRI) scan disclosed multiple bilateral ischemic, mainly subcortical lesions. Despite a favorable clinical evolution under adequate corticotherapy, an MRI performed 3 months later showed an increased number of the previously observed lesions. This observation suggests that in some cases the evolution of central nervous system sarcoid lesions occurs independently from corticotherapy, and that MRI, in spite of its known great sensitivity in detecting those lesions, may not play a role in the follow-up of some patients with neurosarcoidosis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Brain / pathology
  • Brain Diseases / diagnosis*
  • Brain Diseases / drug therapy
  • Brain Diseases / pathology
  • Follow-Up Studies
  • Humans
  • Lung / pathology
  • Lung Diseases / diagnosis
  • Lung Diseases / drug therapy
  • Lung Diseases / pathology
  • Magnetic Resonance Imaging*
  • Male
  • Methylprednisolone / therapeutic use
  • Neuromuscular Diseases / diagnosis*
  • Neuromuscular Diseases / drug therapy
  • Neuromuscular Diseases / pathology
  • Sarcoidosis / diagnosis*
  • Sarcoidosis / drug therapy
  • Sarcoidosis / pathology
  • Tomography, X-Ray Computed

Substances

  • Methylprednisolone