[Neurosarcoidosis: presentation of 14 cases].

BACKGROUND

The involvement of the nervous system in sarcoidosis occurs with a frequency of approximately 5%. The aim of this study was to review the frequency and characteristics of the neurologic manifestations of the a series of sarcoidosis.

METHODS

During a period of 18 years (1974-1991) 270 patients were diagnosed with sarcoidosis in the Hospital de Bellvitge-Prínceps d'Espanya. The diagnosis of neurosarcoidosis was performed in those presenting neurologic symptoms no attributable to other causes. The clinical histories were retrospectively reviewed collecting clinical, radiologic, analytic, therapeutic and evolutive data.

RESULTS

Fourteen patients (5.1%) were diagnosed of neurosarcoidosis. Neurologic symptomatology was the first manifestation of the disease in 12 (85%). All showed extra-neurologic manifestations of sarcoidosis with the lung being the most frequently affected organ (78%). The clinical picture consisted of cranial neuropathy in 11 cases of which nine presented peripheral facial paralysis and 4 cases involvement of the central nervous system. In 13 patients the treatment schedule included glucocorticoids. All the patients (100%) with alteration of the central nervous system continued with active disease at 2 years while this only occurred in 33% of the cases with paralysis of the cranial pairs.

CONCLUSIONS

The frequency of neurosarcoidosis in the authors' series was similar to that described in the literature and its most frequent clinical form was cranial neuropathy. The treatment of choice was glucocorticoid and the involvement of the cranial pairs presents a better prognosis than that of the central nervous system.