Neurosarcoidosis presenting as an anterior horn syndrome.
We report a 43 year old man who developed progressive weakness of all extremities with fasciculation over four months. Neurological examination was consistent with an anterior horn syndrome. CSF examination showed elevated opening pressure and a lymphocytic pleocytosis. The diagnosis of sarcoidosis was confirmed by muscle and lacrimal gland biopsies. He was treated with the combination of corticosteroids and intravenous immunoglobulin with almost complete resolution of his symptoms a few weeks after discharge. We hypothesize that meningeal granulomatous inflammation compressed the exiting anterior roots which resulted in motor dysfunction with preservation of peripheral sensory fibers.
Souayah
Nizar
N
Department of Neurosciences, UMDNJ-New Jersey Medical School, Newark, NJ 07101-1709, USA. souayani@umdnj.edu
Hassan
Ameer E
AE
Krivitskaya
Natalia
N
Lee
Huey-Jen
HJ
Michas-Martin
Andreas
A
Cruz
A Manuel
AM
Cho
Eun-Sook
ES
D000328:Adult; D004576:Electromyography / Q000379:methods; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009134:Muscular Atrophy, Spinal / Q000473:pathology / Q000503:physiopathology*; D009422:Nervous System Diseases / Q000150:complications / Q000175:diagnosis*; D012507:Sarcoidosis / Q000150:complications / Q000175:diagnosis*; D012735:Sexual Dysfunction, Physiological / Q000209:etiology; D013035:Spasm / Q000209:etiology / Q000473:pathology