What are the symptoms of nervous system sarcoidosis?

summary

Sarcoidosis, also known as sarcoidosis, is a chronic granulomatous disease with unknown causes. It can invade multiple organs of the body, with the highest incidence rate of lung and lymph nodes. About 5% of the sarcoidosis patients invade the nervous system and show the manifestation of nervous system damage, which is called nervous system sarcoidosis. According to statistics, about 1 / 3 of the patients have recurrent disease. What are the symptoms of nervous system sarcoidosis?

What are the symptoms of nervous system sarcoidosis?

The severity of symptoms of nervous system damage is related to the activity of nodular granuloma, the location and scope of lesions. Brain damage, nervous system sarcoidosis mainly involves meninges, perimeninges, brain parenchyma, hypothalamus and pituitary（ 1) Chronic meningitis was the main manifestation of meningeal damage. Headache, vomiting, neck rigidity or epilepsy were the main manifestations（ 2) Most cranial nerves may be damaged in patients with arachnoid involvement（ 3) Meningeal involvement is often accompanied by hypothalamic pituitary damage, diabetes insipidus, autonomic nerve dysfunction and abnormal blood prolactin levels（ 4) Brain parenchyma damage is also more common, mainly in periventricular and ependymal involvement, manifested as single or multiple nodular granuloma, patients often have headache and vomiting, optic disc edema, hemiplegia, hemiblind aphasia, multiple granuloma damage can cause dementia, ependymal involvement, often hydrocephalus.

Spinal cord damage is rare. Spinal cord damage in nervous system sarcoidosis is mostly subacute or chronic, with local granuloma infiltration and local space occupying manifestations. The clinical manifestations are low back pain, leg pain, weakness, hypoesthesia or loss, paraplegia, dysuria, etc.

Peripheral nerve damage, spinal nerve involvement in patients with nervous system sarcoidosis is the most common, can be manifested as single neuritis, multiple radiculopathy, Guillain Barre syndrome, symmetric polyneuropathy and other brain nerve damage, facial nerve damage is common, can be manifested as peripheral facial paralysis, hearing impairment, visual impairment and eye movement disorders.

matters needing attention

The patients with nervous system sarcoidosis often have poor prognosis because of easy recurrence and slow progression. The prognosis is poor if there are brain space occupying manifestations, hydrocephalus and intracranial lesions with epilepsy. Therefore, early diagnosis and early treatment can significantly alleviate the disease. In the remission period of the disease, small dose of hormone should be given to maintain, which may improve the prognosis.