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Study of 18 Cases

ALLEN SILVERSTEIN, MD; MARTIN M. FEUER, MD; LOUIS E. SILTZBACH, MD

Arch Neurol. 1965;12(1):1-11.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

The nervous system is uncommonly affected by sarcoidosis. An impressive array of neurologic signs and symptoms may appear when involvement does occur. The purpose of this communication is to present 18 patients with histologically verified sarcoidosis who exhibited neurologic manifestations at some point in their illness. These neurologic manifestations could be related to the three nervous system areas; central nervous system, including brain, spinal cord, and meninges; peripheral nerves; and cranial nerves. Interestingly, cranial and peripheral nerve involvement characteristically occurred in patients whose sarcoidosis was of recent onset, whereas central nervous system lesions commonly manifested themselves later in the course. The site of involvement also influenced prognosis. Facial palsy, a frequent finding, proved to be transitory, while peripheral nerve lesions lasted somewhat longer. Central nervous system lesions, on the other hand, fared relatively poorly with slow recovery which was often incomplete, even with treatment.

Patient Material

The 18 patients with . . . [Full Text PDF of this Article]

Author Affiliations
NEW YORK

From the Division of Thoracic Diseases of the Department of Medicine and the Department of Neurology of the Mount Sinai Hospital.

Footnotes
Submitted for publication July 20, 1964; accepted August 14.

Dr. Feuer is now at Montefiore Hospital, Bronx, NY.

Aided in part by grant AI-02272 from the National Institutes of Allergy and Infectious Diseases, United States Public Health Service, and a grant from the Ed Lee and Jean Campe Foundation, Inc.

"Sarcoidosis is a systemic granulomatous disease of undetermined etiology and pathogenesis. Mediastinal and peripheral lymph nodes, lungs, liver, spleen, skin, eyes, phalangeal bones and parotid glands are most often involved, but other organs or tissues may be affected. The Kveim reaction is frequently positive and tuberculin-type hypersensitivities are frequently depressed. Other important laboratory findings are hypercalciuria and increased serum globulins. The characteristic histologic appearance of epithelioid tubercles with little or no necrosis is not pathognomonic, and tuberculosis, fungal infection, beryllium disease and local sarcoid reactions must be excluded. The diagnosis should be regarded as established for clinical purposes in patients who have consistent clinical features, together with biopsy evidence of epithelioid tubercles or a positive Kveim test." International Conference on Sarcoidosis, Amer Rev Resp Dis 84 (pt 2):171, 1960.

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