[Sensory Jacksonian seizures as initial manifestation of sarcoidosis]

A 46-year old patient is reported presenting with somatosensory focal seizures of either arm as the only manifestation of an otherwise clinically inapparent sarcoidosis. MRI showed signs of a granulomatous leptomeningeal affection. Histological examination of a meningeal biopsy proved the diagnosis of sarcoidosis by demonstrating noncaseating granulomas. There was no other clinical manifestation of sarcoidosis. Chest X-ray was normal and the serum level of angiotensin-converting-enzyme was only slightly elevated. The CD4/CD8 ratio in the bronchoalveolar lavage cell population, however, was clearly abnormal, supporting the role of this diagnostic tool in the diagnosis of sarcoidosis.