Skip to main content
SpringerLink
Log in

Neurosarcoidosis without systemic sarcoidosis

  • Original Articles
  • Published:
European Archives of Psychiatry and Clinical Neuroscience Aims and scope Submit manuscript

Summary

Neurosarcoidosis is a well-recognised complication of systemic sarcoidosis but diagnosis may be difficult if there is no clear evidence of an extracerebral manifestation of the disease. We present the case of a 42-year-old woman with clinical features characteristic of cerebral sarcoidosis including tetraparesis, diabetes insipidus, diencephalic hyperphagia, personality changes, and memory loss. Diagnosis was supported by cerebrospinal fluid (CSF) findings and magnetic resonance imaging (MRI): CSF showed mild lymphocytic pleocytosis, intrathecal production of IgG without oligoclonal bands, and a raised level of lysozyme. MRI revealed multiple contrast-enhanced granulomas at the base of the brain with partial involvement of diencephalic and mesencephalic structures and parts of the spinal cord. There was no evidence of systemic manifestation of sarcoidosis. Administration of corticosteroids led to improvement of the symptoms.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Allen KS, Glickstein M, Arger, PH, Bilaniuk L, Levy DW (1988) Cryptococcosis associated with sarcoidosis: CT and MR findings. J Comput Assist Tomogr 12:420–422

    PubMed  Google Scholar 

  2. Borucki SJ, Nguyen BV, Ladoulis CT, McKendall RR (1989) Cerebrospinal fluid immunoglobulin abnormalities in neurosarcoidosis. Arch Neurol 46:270–273

    PubMed  Google Scholar 

  3. Capp MP, Strautman PR, Kricun ME, Modic MT, Moss AA, Webb WR, Wodd BP (1990) Image interpretation session. Case 9. Radiographics 10:149–151

    Google Scholar 

  4. Cooper SD, Brady MB, Williams JP, Pilgreen KL, Harp DL, Weissmann JR (1988) Neurosarcoidosis: evaluation using computed tomography and magnetic resonance imaging. J Comput Tomogr 12:96–99

    Article  PubMed  Google Scholar 

  5. Delaney P (1977) Neurologic manifestation in sarcoidosis: review of the literature, with a report of 23 cases. Ann Intern Med 87:336–354

    PubMed  Google Scholar 

  6. Hayes WS, Sherman JL, Stern BJ, Citrin CM, Pulaski PD (1987) MR and CT evaluation of intracranial sarcoidosis. Am J Roentgenol 149:1043–1049

    Google Scholar 

  7. Kinnman J, Link H (1984) Intrathecal production of oligoclonal IgM and IgG in CNS sarcoidosis. Acta Neurol Scand 69: 97–106

    PubMed  Google Scholar 

  8. Lawrence EC, Brousseau KP, Berger MB, Kurman CC, Marcon L, Nelson DL (1988) Elevated concentrations of soluble interleukin-2 receptors in serum samples and bronchoalveolar lavage fluids in active sarcoidosis. Am Rev Respir Dis 137: 759–746

    PubMed  Google Scholar 

  9. McHugh PR (1986) Satiety and its disorders. In: Asbury AK, McKhann GM, McDonald WI (eds) Disorders of the nervous systems. Heinemann, London, pp 643–650

    Google Scholar 

  10. Mende D, Suchenwirth RMA (1990) Neurosarkoidose vergleichende Analyse des klinischen Profils anhand von 537 Beobachtungen aus der Weltliteratur bis 1963 und von 1976–1988. Fortschr Neurol Psychiatr 58:7–18

    PubMed  Google Scholar 

  11. Miller DH, Kendall BE, Barter S, Johnson G, MacManus DG, Logsdail SJ, Ormerod IEC, McDonald WI (1988) Magnetic resonance imaging in central nervous system sarcoidosis. Neurology 38:378–383

    PubMed  Google Scholar 

  12. Mitchell JD, Yap PL, Milne LA, Lachmann PJ, Pentland B (1985) Immunological studies on the cerebrospinal fluid in neurological sarcoidosis. J Neuroimmunol 7:249–253

    Article  PubMed  Google Scholar 

  13. Nakao K, Noma K, Sato B, Yano S, Yamamura Y, Tachibana T (1978) Serum prolactin levels in 80 patients with sarcoidosis. Eur J Clin Invest 8:37–40

    PubMed  Google Scholar 

  14. Nesbit GM, Miller GM, Baker HL, Ebersold MJ, Scheithauer BW (1989) Spinal cord sarcoidosis: a new finding at MR imaging with Gd-DTPA enhancement. Radiology 173:839–843

    PubMed  Google Scholar 

  15. Oksanen V (1986) Neurosarcoidosis: clinical presentations and course in 50 patients. Acta Neurol Scand 73:283–290

    PubMed  Google Scholar 

  16. Oksanen V, Fyhrquist F, Grönhagen-Riska C, Somer H (1985) CSF angiotensin-converting enzyme in neurosarcoidosis. Lancet I:1050–1051

    Article  Google Scholar 

  17. Oksanen V, Fyhrquist F, Somer H, Grönhagen-Riska C (1985) Angiotensin converting enyme in cerebrospinal fluid: a new assay. Neurology 35:1220–1223

    PubMed  Google Scholar 

  18. Oksanen V, Grönhagen-Riska C, Tikanoja S, Somer H, Fyhrquist F (1986) Cerebrospinal fluid lysozyme and β2-microglobulin in neurosarcoidosis. J Neurol 73:79–87

    Google Scholar 

  19. Schlegel U (1987) Neurosarkoidose: Diagnostik und Therapie. Fortschr Neurol Psychiatr 55:1–15

    PubMed  Google Scholar 

  20. Scott TF, Seay AR, Goust JM (1989) Pattern and concentration of IgG in cerebrospinal fluid in neurosarcoidosis. Neurology 39:1637–1639

    PubMed  Google Scholar 

  21. Smith AS, Meisler DM, Weinstein MA, Tomsak RL, Hanson MR, Rudick RA, Farris BK, Ransohoff RM (1989) High-signal periventricular lesions in patients with sarcoidosis: neurosarcoidosis or multiple sclerosis. Am J Roentgenol 153:147–152

    Google Scholar 

  22. Stern BJ, Krumholz A, Johns C, Scott P, Nissim J (1985) Sarcoidosis and its neurological manifestation. Arch Neurol 42: 909–917

    PubMed  Google Scholar 

  23. Stern BJ, Griffin DE, Luke RA (1987) Neurosarcoidosis: cerebrospinal fluid lymphocyte subpopulations. Neurology 37: 878–881

    PubMed  Google Scholar 

  24. Strausz J, Müller-Quenheim J, Ferlinz R (1989) Sezernierter Interleukin-2-Rezeptor als Aktivitätsparameter der Sarkoidose. Dtsch Med Wochenschr 114:744–749

    PubMed  Google Scholar 

  25. Stuart CA, Neelon A, Lebovitz HE (1978) Hypothylamic insufficiency: the cause of hypopituitarism in sarcoidosis. Ann Intern Med 88:589–594

    PubMed  Google Scholar 

  26. Wiederholt WC, Siekert RG (1965) Neurological manifestations of sarcoidosis. Neurology 15:1147–1154

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurology, University of Tübingen, Hoppe-Seyler-Strasse 3, W-7400, Tübingen, Federal Republic of Germany

    Norbert Sommer, Michael Weller, Horst Wiethölter & Johannes Dichgans

  2. Department of Neuroradiology, University of Tübingen, Hoppe-Seyler-Strasse 3, W-7400, Tübingen, Federal Republic of Germany

    Dirk Petersen

Authors
  1. Norbert Sommer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michael Weller
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Dirk Petersen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Horst Wiethölter
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Johannes Dichgans
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sommer, N., Weller, M., Petersen, D. et al. Neurosarcoidosis without systemic sarcoidosis. Eur Arch Psychiatry Clin Nuerosci 240, 334–338 (1991). https://doi.org/10.1007/BF02279763

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02279763

Key words

Search

Navigation