A Case of Neurosarcoidosis Presenting with Facial Diplegia and Myelitis

J Korean Assoc EMG Electrodiagn Med 2008;10(1):42-45.
Published online June 1, 2008.

Abstract

Background & Significance: Neurosarcoidosis is a chronic, multisystem, granulomatous, inflammatorydisease of unknown etiology in the nervous system. Neurologic complications of sarcoidosis occur inapproximately 5% of patients.Case: A 58-year-old woman was admitted with fever, chest tightness and urinary incontinence. On theneurological examination, bilateral peripheral type facial palsy and paresthesia between T2 and L1 levelwere noted. Electrophysiological studies showed normal nerve conduction velocities and normal sensoryevoked potentials. Cerebrospinal fluid study showed mild pleocytosis and an increased amount of protein.There were normal levels of angiotensin converting enzyme and negative oligoclonal bands. Whole bodypositron emission tomography revealed focal uptakes at the right hilum, right lower paratrachea area andsubcarina. In the thoracoscopic biopsy of hilar lymph node, small granulomatous inflammation withoutcaseation necrosis was reported.Conclusions and Comments: We report a case of neurosarcoidosis manifestated by facial diplegia andmyelitis verified by thoracoscopic mediastinal biopsy.

Key Words: Neurosarcoidosis, Facial diplegia, Myelitis