Rinsho Shinkeigaku (Clinical Neurology)

Case Report

A case of neurosarcoidosis with swelling and gadolinium enhancement of spinal nerve roots on magnetic resonance imaging

Masato Ishibashi, M.D., Noriyuki Kimura, M.D., Yoshiaki Takahashi, M.D., Yuki Kimura, M.D., Yusuke Hazama, M.D. and Toshihide Kumamoto, M.D.

Department of Internal Medicine III, Oita University, Faculty of Medicine

An 80-year-old woman was admitted to our hospital because of developed sense of constriction in the trunk and gradually progressive numbness and muscle weakness in the upper and lower extremities. Cerebrospinal fluid analysis showed increased cell count and protein level. Gadolinium enhanced magnetic resonance imaging (MRI) of spine showed the enhancement and swelling of bilateral nerve root in the cervical and lumbar segments. Although chest computed tomography showed neither bilateral hilar lymphoadenopathy nor lung lesions and serum angiotensin converting enzyme and lysozyme (ACE) were normal, tuberculin skin test was negative and cell count and CD4/CD8 elevated in bronchoalveolar lavage fluid. Biopsy specimen of scalene lymph node showed noncaseating granuloma. The patient was treated with oral predonisolone, which improved her symptoms and abnormalities on MRI. It is important to consider neurosarcoidosis in the differential diagnosis of polyradiculopathy with swelling and gadolinium enhancement of spinal nerve roots.
Full Text of this Article in Japanese PDF (365K)

(CLINICA NEUROL, 51: 483|486, 2011)
key words: neurosarcoidosis, polyradiculoneuropathy, magnetic resonance imaging of spine, swelling of spinal nerve roots, gadolinium enhancement

(Received: 14-Dec-10)