Neurosarcoidosis. A report of 5 cases

Neurological involvement in sarcoidosis occurs in about 5% of cases, and both the central and peripheral nervous systems may be affected. In the majority of patients, characteristic features of the disease are present in other systems. Five cases of neurosarcoidosis are described in which serious neurological involvement was the presenting manifestation of the disease. The chest radiographs were abnormal in all patients and this drew attention to the diagnosis. Evidence of sarcoid was obtained from biopsy specimens in each case; in 4 from lymph nodes and in 1 from a transbronchial biopsy specimen. All patients were treated with prednisone, although in 2 the dose had to be reduced because of side-effects and azathioprine was introduced. All became asymptomatic; in 2 cases therapy was withdrawn while in the other 3 maintenance therapy was necessary, 2 requiring replacement thyroxine and lypressin.