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September 1985

Sarcoidosis and Its Neurological Manifestations

Author Affiliations

From the Divisions of Neurology (Drs Stern and Krumholz) and Pulmonary Medicine (Drs Scott and Nissim), Sinai Hospital of Baltimore, and the Departments of Neurology (Drs Stern and Krumholz) and Medicine (Drs Johns, Scott, and Nissim), The Johns Hopkins Hospital and University, Baltimore.

Arch Neurol. 1985;42(9):909-917. doi:10.1001/archneur.1985.04060080095022

• Neurosarcoidosls is a disorder that is difficult to diagnose and manage. We assessed its neurological manifestations in 649 patients seen at The Johns Hopkins Hospital, Baltimore, from 1975 through 1980. Neurological problems could be attributed to neurosarcoidosis in 33 patients (5.1%). The presenting manifestation of sarcoidosis was neurological in 16 (48%) of them. Cranial neuropathy was the most frequent problem, and a peripheral facial nerve palsy was the single most common abnormality. Other manifestations were aseptic meningitis, hydrocephalus, parenchymatous disease of the central nervous system, peripheral neuropathy, and myopathy. Three-quarters of the patients were treated with steroids. The outcome was good in 27 (82%) of 33 episodes of neurological dysfunction in 25 patients with a well-documented clinical course. A thorough investigation of patients with suspected neurosarcoidosis is recommended to establish the diagnosis, delineate the extent of disease, and guide therapy.

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