[Sarcoidosis presenting as partial seizures. Report of one case].
The nervous system is affected in 10% of patients with sarcoidosis. However, neurological disturbances are rarely the first manifestation of the disease. We report a 36-year-old woman presenting with partial seizures that generalized secondarily. Magnetic resonance showed a left parietal cortical-subcortical lesion with a minimal mass effect, moderate vasogenic edema and intense enhancement with intravenous contrast. A magnetic resonance spectroscopy disclosed a low aggressiveness profile, compatible with an inflammatory lesion. Angiotensin converting enzyme levels were normal. The lesion was excised and the pathological study showed the presence of granulomas with dubious necrosis. The patient was treated with antituberculous drugs. One year later, the lesion had grown and a thorax CT scan showed numerous mediastinal and hilar lymphadenopathies. A new determination of angiotensin converting enzyme disclosed elevated levels and the biopsy of mediastinal lymph nodes confirmed the presence of sarcoidosis.
Fernández-Rey
Cristina Lidia
CL
Sección de Neuroimagen, Servicio de Radiodiagnóstico, Hospital Universitario Central de Asturias, Oviedo, Spain. cristinarey80@hotmail.com
Saiz Ayala
Antonio
A
Alvarez-Uría Tejero
María Jesús
MJ
Santamarta Liébana
Elena
E
Costilla García
Serafín
S
D000328:Adult; D004828:Epilepsies, Partial / Q000209:etiology*; D005260:Female; D006801:Humans; D007703:Peptidyl-Dipeptidase A / Q000097:blood; D017565:Sarcoidosis, Pulmonary / Q000150:complications*
D007703:Peptidyl-Dipeptidase A