Mattiassich Georg, Schubert Heinrich, Hutarew Georg, Wechselberger Gottfried
Trauma Center Linz-Teaching Hospital of the Paracelsus Medical University Salzburg, Linz, Austria.
BMJ Case Rep. 2012 Nov 28;2012:bcr2012007430. doi: 10.1136/bcr-2012-007430.
A 79-year-old woman was admitted complaining of progressive weakness and numbness of the right hand. The patient was otherwise healthy. The patient's history was unremarkable. Clinical and electrophysiological examination revealed a compression of the ulnar nerve in the ulnar sulcus and in Guyon's canal. Ultrasound evaluation showed a suspicious tumour proximal to the elbow close to the ulnar nerve. The ulnar sulcus was then released and an epineural and perineural lesion 3-4 cm proximal to the sulcus was excised under microscope. The histopathology confirmed the lesion as non-caseating sarcoid granulomas. The patient showed no other signs of systemic sarcoidosis, as neuropathy was the only symptom and the condition improved postoperatively. Sensory deficits and paraesthesia resolved fully. The extension of the minor finger remained slightly inferior compared with the not affected side. Sarcoid neuropathy is a rare neurological complication of sarcoidosis and has to be included in differential diagnosis of nerve conduction impairments.
一名79岁女性因右手进行性无力和麻木入院。该患者其他方面健康。患者病史无异常。临床和电生理检查发现尺神经在尺神经沟和Guyon管受压。超声评估显示肘部近端靠近尺神经处有一个可疑肿瘤。随后松解尺神经沟,并在显微镜下切除沟近端3 - 4厘米处的神经外膜和神经束膜病变。组织病理学证实该病变为非干酪样结节病肉芽肿。患者无其他系统性结节病体征,因为神经病变是唯一症状且术后病情改善。感觉障碍和感觉异常完全消失。与未受影响侧相比,小指伸展仍略差。结节病性神经病变是结节病罕见的神经并发症,在神经传导障碍的鉴别诊断中必须予以考虑。