Sarcoidosis with basal ganglial infiltration presenting as Parkinsonism
- Spyridon Papapetropoulos,
- Alexandra Guevara,
- Michael Georgiou,
- Georgia Mitsi,
- Carlos Singer,
- Sylvia Delgado
- Spyridon Papapetropoulos, spapapetropoulos{at}med.miami.edu
- Published 17 March 2009
Summary
The present report describes the case of a woman with symptoms of Parkinsonism (slow and monotonous speech, left foot dragging and micrographia) that gradually developed over a period of 12 months. She had a 10-month history of untreated, asymptomatic sarcoidosis diagnosed by routine biopsy of an enlarged left supraclavicular lymph node. After her condition deteriorated, a brain MRI showed right basal ganglial areas of haemorrhage with perilesional fast fluid-attenuated inversion-recovery (FLAIR) abnormalities. Right stereotactic frame-based brain parenchymal biopsy of the lesion site revealed reactive central nervous system (CNS) tissue with perivascular chronic inflammation and non-caseating granulomas consistent with definite neurosarcoidosis. The patient was started on a high dose of prednisone with good initial response. When mild progression was noted within the next 12 months azathioprine was added to her treatment. The patient’s neurological status has been stable without progression of her Parkinsonian symptomatology.
Footnotes
-
Competing interests: SP is currently an employee of Biogen Idec. SP has worked as a consultant for Gerson Lehrman Group Councils and has received research grants from the National Institutes of Health (NIH), the National Parkinson Foundation, the Muscular Dystrophy Association, the Alzheimer Association, the Stanley Glaser Foundation, the University of Miami and the Institute of Ethnomedicine. SP has received honoraria from Intec Pharma.
-
Patient consent: Patient/guardian consent was obtained for publication.
