[A case of central nervous system sarcoidosis, presenting with psychomotor seizure]

A rare case of neurosarcoidosis presenting with psychomotor seizure is reported. A 35-year-old woman was admitted to our ward for further evaluation of syncopal attacks and suspected sarcoidosis. The patient had a history of syncopal attacks for about 15 years prior to admission; however, the pathogenesis was not clarified in spite of various examinations. Three months prior to admission, left peripheral facial nerve palsy, bilateral hypopion and bilateral hilar lymphadenopathy on plain chest film were noted at the departments of neurosurgery and ophthalmology of our hospital. She was referred and admitted to our ward. The diagnosis of sarcoidosis was made by scalene node biopsy. The syncopal attacks could not be controlled by several anticonvulsant agents. Although no significant findings were observed on brain CT and cerebral angiography, spike wave was revealed on electroencephalography (EEG) in the parieto-temporal lead. The syncopal attacks were diagnosed psychomotor seizures from both the clinical features and the EEG findings. We concluded that syncope was caused by neurosarcoidosis. The patient was prescribed steroid with much improvement of these symptoms.