An Atypical Presentation of a Patient With Neurosarcoidosis: A Case Report

Neurosarcoidosis is a disease in which noncaseating granulomas, characteristic of sarcoidosis, are found within organs of the nervous system such as the brain and spinal cord. This case report highlights a 57-year-old male with worsening bilateral lower extremity weakness and numbness in addition to ptosis and oculomotor nerve palsy of the right eye. Computed tomography (CT) imaging showed mediastinal and hilar lymphadenopathy, which raised suspicion for neurosarcoidosis. Multiple biopsies were taken from lymph nodes in the mediastinal region, which resulted in non-necrotizing epithelioid cell granulomas, consistent with the suspected neurosarcoidosis. Medical providers must include neurosarcoidosis within a much broader differential diagnosis when encountering patients that present with a similar presentation shown in this case report so that treatment can be promptly initiated as soon as possible.