Orimo S, Umeda Y, Kurosawa T, Arai M, Hiyamuta E
Rinsho Shinkeigaku. 1989 Jun;29(6):781-3.
A case of sarcoidosis presenting ataxic hemiparesis was reported. A 25-year-old man was admitted to Kanto Teishin Hospital because of slight weakness and dysesthesia in the right side of his body. His physical findings were normal. Neurological findings disclosed mild right hemiparesis (MMT 4+), cerebellar signs and mild dysesthesia in the same side. Laboratory findings were within normal limits except for elevated serum ACE and lysozyme. Chest roentgenogram showed bilateral hilar lymphadenopathy and TBLB disclosed sarcoid granuloma. Though brain CT, brain MRI and cerebral angiography were within normal limits, the neurological features were thought to be due to sarcoidosis. They disappeared along with the decrease of ACE and lysozyme. This is the first report of ataxic hemiparesis due to sarcoidosis, and it is interesting in that ataxic hemiparesis, which is one of signs of diseases in central nervous system, is the first manifest clinical feature of sarcoidosis.
报告了一例以共济失调性偏瘫为表现的结节病病例。一名25岁男性因身体右侧轻度无力和感觉异常入住关东帝心医院。其体格检查结果正常。神经系统检查发现轻度右侧偏瘫（MMT 4+）、小脑体征以及同侧轻度感觉异常。实验室检查结果除血清ACE和溶菌酶升高外均在正常范围内。胸部X线片显示双侧肺门淋巴结肿大，经支气管肺活检发现结节病肉芽肿。尽管脑部CT、脑部MRI和脑血管造影均正常，但神经系统症状被认为是由结节病引起的。它们随着ACE和溶菌酶的降低而消失。这是首例关于结节病导致共济失调性偏瘫的报告，有趣的是，共济失调性偏瘫作为中枢神经系统疾病的体征之一，是结节病的首个明显临床特征。
