[Spinal cord sarcoidosis: diagnostic and therapeutic problems]

Three cases of sarcoidosis with spinal cord involvement are reported. The diagnosis in each case was very difficult, being mistaken with tuberculosis in two of the patients and with paraneoplasic myelopathy in the other one. Initial treatment was incorrect for this reason. MRI without contrast was normal, but showed the existence of lesions in two cases after gadolinium administration. Symptoms improved in two patients with prednisone, but they got worse after tapering dose. Spinal sarcoidosis is very rare, but its diagnosis most be considered and MRI with gadolinium should be performed in subacute or chronic myelopathies. Treatment with prednisone should be prolonged.