Tsao Chang-Yong, Lo Warren D, Rusin Jerome A, Henwood Maria J, Boue Daniel R
Department of Pediatrics and Neurology, The Ohio State University, OH, USA.
Brain Dev. 2007 Sep;29(8):514-8. doi: 10.1016/j.braindev.2006.12.011. Epub 2007 Feb 16.
Sarcoidosis is uncommon in children. Although isolated neurosarcoidosis has been seen in 15% adults with sarcoidosis, pediatric neurosarcoidosis is rarely reported. Neurosarcoidosis may present with cranial neuropathy, including facial palsy, optic nerve or other cranial nerve involvement, peripheral neuropathy, or manifestations of the central nervous system affecting the hypothalamus, pituitary gland, cerebral cortex, cerebellum, meninges, and spinal cord. The useful diagnostic investigations include magnetic resonance imaging of the brain and spinal cord, cerebrospinal fluid studies, brain and meningeal biopsy if feasible, chest radiography to reveal sarcoidosis, angiotensin-converting enzyme level in the serum or cerebrospinal fluid, and Kveim test when available. We herein report a case of isolated brain biopsy-confirmed neurosarcoidosis in a 17-year-old boy presenting with severe unilateral headache and multiple brain and spinal cord MRI lesions mimicking central nervous system metastases.
结节病在儿童中并不常见。虽然在15%的成年结节病患者中可见孤立性神经结节病，但小儿神经结节病鲜有报道。神经结节病可能表现为颅神经病变，包括面神经麻痹、视神经或其他颅神经受累、周围神经病变，或影响下丘脑、垂体、大脑皮层、小脑、脑膜和脊髓的中枢神经系统表现。有用的诊断检查包括脑和脊髓的磁共振成像、脑脊液检查、可行时的脑和脑膜活检、用于揭示结节病的胸部X线摄影、血清或脑脊液中的血管紧张素转换酶水平，以及有条件时的克维姆试验。我们在此报告一例17岁男孩的孤立性经脑活检确诊的神经结节病病例，该男孩表现为严重的单侧头痛以及多个脑和脊髓MRI病变，酷似中枢神经系统转移瘤。
