The role of MRI and nerve root biopsy in the diagnosis of neurosarcoidosis.
OBJECTIVE
Neurological involvement occurs in 5-15% of patients with sarcoidosis and isolated "neurosarcoidosis" occurs in less than 1% of all cases. Classical clinical presentations have been described, such as bilateral facial palsy, but often the disease presents insidiously with varied signs and symptoms. We present a patient who required biopsy of a lumbar nerve root for diagnosis of chronic, progressive neurosarcoidosis and review the literature with an emphasis on diagnosis.


METHODS
We have reviewed a patient who presented with signs and symptoms related to infiltration of her meninges and nerve roots by sarcoidosis. All pertinent history and physical information was taken from interviews with the patient and review of her chart. Laboratory, radiographic, and pathological investigations are presented.


CONCLUSIONS
A high index of suspicion is required for the diagnosis of neurosarcoidosis. Gadolinium-enhanced MRI is useful but the findings are often nonspecific, and there should be a low threshold for biopsy whenever the diagnosis is considered.
Moore
F G
FG
Department of Neurology, Montreal Neurological Institute and Hospital, McGill University, Quebec, Canada.
Andermann
F
F
Richardson
J
J
Tampieri
D
D
Giaccone
R
R
D001707:Biopsy, Needle; D001921:Brain / Q000473:pathology; D002574:Cervical Vertebrae / Q000473:pathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D009422:Nervous System Diseases / Q000175:diagnosis* / Q000473:pathology; D012507:Sarcoidosis / Q000175:diagnosis* / Q000473:pathology; D013116:Spinal Cord / Q000473:pathology; D013126:Spinal Nerve Roots / Q000473:pathology*; D013904:Thoracic Vertebrae / Q000473:pathology