[Neurologic involvement in sarcoidosis. Federation of Systemic Diseases of Grenoble].

OBJECTIVE

Study the incidence, clinical features, prognosis and diagnostic and therapeutic strategies in neurological lesions of sarcoidosis.

PATIENTS AND METHODS

The 207 cases of sarcoidosis followed at the Grenoble University Hospital between 1992 and 1998 were identified. After collecting data, the cases with neurological signs related to sarcoidosis were selected.

RESULTS

Sixteen patients (7.7%) had neurosarcoidosis. Ten had central nervous system involvement, with 5 reaching the hypothalamus and pituitary glands, 2 cases of meningoencephalitis, 2 pseudotumoral lesions, and 1 bitemporal lesion. Six had peripheral nervous system involvement, 3 had facial palsies and 3 had neuropathies. Laboratory tests were not contributive to diagnosis. Ten magnetic resonance imaging series were pathological out of 11 performed. Three central nervous system biopsies were obtained. Corticosteroid therapy was the most frequent treatment. For hypothalamic and pituitary dysfunction, the only treatment was substitutive hormone therapy. The course was favorable in 11 cases, stable in 4 cases. Symptoms worsened despite treatment in only 1 case.

CONCLUSION

The incidence of neurosarcoidosis may be much higher than is generally realized. The association of suggestive MRI signs, and clinical and laboratory findings evoke the diagnosis. Brain biopsy remains necessary for the pseudotumoral forms and the primitive neurological forms.