[Neurosarcoidosis. Apropos of a case and review of the literature].

INTRODUCTION

Sarcoidosis is a disease of unknown cause, characterized by the presence of non-caseating granulomas in many organs. Neurological involvement is rare and only occurs in 5-7% of the patients, usually during the first two years after onset of the disease. The neurological findings vary depending on the site of the lesions. The treatment of choice is with glucocorticoids for at least 6-12 months. Some patients in whom this treatment fails or leads to intolerable side-effects may respond well to immunosuppressive drugs and/or radiotherapy.

CLINICAL CASE: We present the case of a 31 year old man who complained of severe headache. He was referred to our department with the diagnosis of neurosarcoidosis and progressive neurological deterioration on conventional treatment. Holocranial radiotherapy with Co60 (30 Gy in 10 sessions) was given. Three months after this treatment had been given there was clinical improvement.

CONCLUSIONS

Radiotherapy may be an effective alternative when other treatment fails or glucocorticoids cause intolerable toxicity. The recommended dose is between 12 and 30 Gy, divided into 150-300 cgy/day.