Multifocal Epidural Neurosarcoidosis Causing Spinal Cord Compression: A Case Report.

Area of Science:

• Neurology
• Oncology
• Radiology

Background:

• Neurosarcoidosis is a rare manifestation of sarcoidosis involving the nervous system.
• Extramedullary epidural neurosarcoidosis is an exceptionally rare subtype, often presenting with significant neurological deficits.

Observation:

• A 46-year-old woman presented with sensory loss, gait disturbance, and urinary incontinence, but no motor deficits.
• Spine MRI revealed multifocal epidural lesions with T5 spinal cord compression.
• CT-guided biopsy confirmed noncaseating granulomas indicative of neurosarcoidosis.

Findings:

• The patient received dexamethasone and a subsequent oral prednisone taper.
• She experienced a complete neurological recovery and remains employed.
• This case highlights a successful non-surgical treatment approach.

Implications:

• Multifocal epidural neurosarcoidosis with myelopathy can be managed conservatively with medical therapy if severe motor deficits are absent.
• Early diagnosis and prompt treatment are crucial for favorable outcomes in neurosarcoidosis.
• This case expands the understanding of treatment options for spinal neurosarcoidosis.