Neuro-ophthalmological findings in sarcoidosis.
OBJECTIVE
This review emphasizes the importance of neuro-ophthalmological signs and symptoms in sarcoidosis. The presence of ophthalmological and neuro-ophthalmological findings may lead to diagnosis of the disease and the initiation of adequate treatment.


METHODS
Patients who had been diagnosed with neurosarcoidosis during the period 1990 - 2001 were identified from the departmental diagnostic index. The history, clinical, laboratory and imaging data of patients were analysed.


RESULTS
Fifteen patients were identified, four men and 11 women, with a mean age of 44.1 years (range 26-65 years). In six of the 15 (40%), neurological deficits were the initial symptoms. Nine (60%) had known sarcoidosis at the time of presentation. Ten patients (66%) had ophthalmological/neuro-ophthalmological symptoms and signs.


CONCLUSIONS
Neuro-ophthalmological symptoms may develop early in neurosarcoidosis. If neuro-ophthalmological symptoms arise in patients with established biopsy-proven sarcoidosis, the diagnosis is usually easy to make. However, a number of patients with neurosarcoidosis may present with neuro-ophthalmic symptoms before systemic involvement becomes obvious. In this situation the diagnosis is challenging, and the major goal is to establish the presence of systemic sarcoidosis.
Heuser
Kjell
K
Department of Neurology, Rikshospitalet, University of Oslo, Oslo, Norway. kjell.heuser@rikshospitalet.no
Kerty
Emilia
E
D000328:Adult; D000368:Aged; D003389:Cranial Nerve Diseases / Q000175:diagnosis* / Q000188:drug therapy; D004576:Electromyography; D005062:European Union; D005128:Eye Diseases / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015840:Oculomotor Nerve Diseases / Q000175:diagnosis / Q000188:drug therapy; D009886:Ophthalmoplegia / Q000175:diagnosis / Q000188:drug therapy; D011241:Prednisone / Q000627:therapeutic use; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D012507:Sarcoidosis / Q000175:diagnosis* / Q000188:drug therapy; D015899:Tomography, Emission-Computed, Single-Photon; D015845:Tonic Pupil / Q000175:diagnosis / Q000188:drug therapy
D005938:Glucocorticoids; D011241:Prednisone