TY - JOUR T1 - Many faces of neursarcoidosis! JF - European Respiratory Journal JO - Eur Respir J VL - 38 IS - Suppl 55 SP - p3721 AU - Nelson Marçal AU - Margarida Aguiar AU - Joana Pimentel AU - Inês Claro AU - Ana Cristina Mendes AU - Antonio Bugalho de Almeida Y1 - 2011/09/01 UR - http://erj.ersjournals.com/content/38/Suppl_55/p3721.abstract N2 - Nervous system infiltration occurs in approximately 5% of patients with sarcoidosis; it is associated with a less favorable course and accounts for a disproportionate amount of disability.Our aim was to evaluate clinical manifestations of patients with neurosarcoidosis, their demographics, and form of presentation, extra-neurological involvement and therapy.We performed a retrospective analysis of 23 patients' clinical records (5,1%) out of a total of 450 with biopsy proven or high clinical suspicion of sarcoidosis with neurological involvement. Five males, 20 caucasian, mean age of 47,8±9,9 years with mean follow-up of 10,4±8,2 years (min. 1 and max. 23 years). At presentation, in 10 patients, neurologic symptoms. Twenty-one patients had further involvement of at least a second organ and 18 also had pulmonary compromise.Most patients (n=15) had III, IV, VI or VII cranial nerve palsy conditioning dysarthria and diplopia. Three patients had peripheral neuropathy conditioning mainly paresthesia, two had headache, one had spastic paraparesis and one had extensive optic chiasm involvement conditioning almost total blindness. One of these patients had osmotic receptor dysregulation conditioning high sodium levels, a condition never yet reported in sarcoidosis and another presented with a rapidly progressive dementiaAll patients except for 3 were submitted to steroid therapy and 5 still required the association of a second imunosupressor. Three patients were treated with Infliximab, 2 with total resolution of neurological symptoms.In conclusion, most patients had localized disease affecting essentially the base of the brain however sarcoidosis' neurologic manifestations can be diverse and disabling, conditioning an aggressive approach. ER -