PDF(Pubmed)
Abstract：
Sarcoidosis is an immune-mediated disease that can involve multiple systems. Sarcoidosis of the nervous system or neurosarcoidosis may present as cranial mononeuropathy, hypothalamic involvement, aseptic meningitis, granulomatous inflammation in the brain parenchyma or spinal cord, peripheral neuropathy, and, in rare cases, as myopathy and benign intracranial hypertension. The most common cranial nerve involvement is the facial nerve, which can present as unilateral or bilateral facial nerve palsy, often with recurrent episodes. Involvement of other cranial nerves such as the second and eighth cranial nerves has also been reported. Granulomatous inflammation in the spinal cord presents as myelopathy or radiculopathy. Peripheral neuropathy can manifest as mononeuropathy, mononeuritis multiplex, or generalized sensory-motor neuropathy. Carpal tunnel syndrome is more common in patients with sarcoidosis compared to the general population. Here, we describe the case of a 40-year-old female who presented with heaviness of the head and blurred vision, with a prior history of left-sided Bell\'s palsy. Bilateral papilledema was observed during the fundus examination. MRI of the brain revealed signs suggestive of benign intracranial hypertension. The cerebrospinal fluid (CSF) opening pressure was measured at 40 cmH2O. Biopsy of bilateral hilar lymphadenopathy indicated granulomatous inflammation consistent with sarcoidosis. The patient was started on steroids and acetazolamide, and she had a dramatic improvement in symptoms.
摘要：
结节病是一种免疫介导的疾病，可能涉及多个系统。神经系统结节病或神经结节病可表现为颅单神经病，下丘脑受累,无菌性脑膜炎,脑实质或脊髓肉芽肿性炎症，周围神经病变,and,在极少数情况下，肌病和良性颅内高压.最常见的颅神经受累是面神经，可表现为单侧或双侧面神经麻痹，经常反复发作。还报道了其他颅神经如第二和第八颅神经的参与。脊髓肉芽肿性炎症表现为脊髓病或神经根病。周围神经病变可以表现为单神经病,多发性单神经炎,或广泛性感觉运动神经病。与普通人群相比，结节病患者的腕管综合征更为常见。这里,我们描述了一个40岁的女性，她头部沉重，视力模糊，有左侧Bell氏麻痹史.眼底检查期间观察到双侧乳头水肿。脑部MRI显示提示良性颅内高压的征象。在40cmH2O下测量脑脊液(CSF)开口压力。双侧肺门淋巴结肿大活检提示肉芽肿性炎症符合结节病。病人开始服用类固醇和乙酰唑胺，她的症状有了很大的改善.
