pulmonary sarcoid on cervical spine x ray

Neurodiagnostic tests may help rule out other differentials such as infection and malignancy. In evaluating peripheral neuropathy, it is important to rule out other common causes of neuropathy such as hyperglycemic states, vitamin deficiencies, kidney failure, and toxins. Thermal threshold testing may be used for small-fiber neuropathy. Tests to conduct include ophthalmologic exam (including optical coherence tomography), nasal/sinus examination, chest x-ray (for perihilar lymphadenopathy), angiotensin-converting enzyme (ACE) assay (not specific), and in rare cases a magnetic resonance, gallium or fluorodeoxyglucose emission tomographic scan for areas of inflammation that may be biopsied. If neurosarcoidosis is suspected, it is important to assess for signs of systemic diseases, such as the skin, lymph nodes, and lungs. However, the index of suspicion is lower and thus much more difficult in cases where a patient is not known to have sarcoid but has neurologic abnormalities. Unfortunately, there is no diagnostic marker for neurosarcoidosis.

Neurosarcoidosis should be considered in patients with sarcoidosis who develop neurologic abnormalities. Patients with simple partial or complex partial seizures may have a better prognosis in comparison to generalized tonic-clonic seizures.ĭepending on the location of the disease in the brain, the patient may also present with: In gathering a history, the first sign of neurosarcoidosis may be seizures, which generally confers a poor prognosis.

It is one of the several important causes of pachymeningitis. Meningitis may present with either leptomeningeal or pachymeningeal involvement. During the exam, it is important to assess for papilledema and mental status as psychiatric abnormalities may also occur. Chronic meningitis with basal meningeal involvement is a common manifestation of neurosarcoidosis. Cerebellar signs, such as ataxia, may be present with cerebellar involvement. Another cranial nerve that may be affected is the vestibulocochlear nerve causing balance and hearing problems. Carpal tunnel may also be more frequent in sarcoidosis patients than in the rest of the population. The facial nerve is the most common cranial nerve affected, which may mimic Lyme disease. Heerfordt syndrome is a rare manifestation of neurosarcoidosis which presents with facial nerve palsy and the presence of parotid gland enlargement, anterior uveitis, and fever. Symptoms of neurosarcoidosis may be multifocal, commonly seen first in the cranial nerves. neurogenic diabetes insipidus), myelopathy or radiculopathy if the spinal cord is affected (in rare cases cauda equina polyradiculopathy may occur), hydrocephalus, meningitis, mononeuropathy, mononeuritis multiplex, carpal tunnel, and muscle involvement which may cause proximal myopathy and muscle atrophy. Common features of central or peripheral nervous system involvement include cranial mononeuropathy involving the facial nerve, neuroendocrine dysfunction involving the hypothalamus (i.e.

Pulmonary sarcoid on cervical spine x ray