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Unusual Neurological Manifestations in Sarcoidosis: A Diagnostic Challenge

This case study presents a 29-year-old female with sensory disturbance and facial palsy. Extensive tests reveal bilateral facial palsy and Adie's pupil related to sarcoidosis with lung involvement. The presentation highlights the complexities of diagnosing neurosarcoidosis.

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Unusual Neurological Manifestations in Sarcoidosis: A Diagnostic Challenge

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  1. CASE PRESENTATION • DEPARTMENT OF NEUROLGY • Sheba medical center

  2. History • 29yrs, female • Past history: Mild Asthma • 5 days prior to admission, sensory disturbance, Rt. torso: T8 to ear • On day of admission – Lt. peripheral facial palsy

  3. Exam • Physical exam normal • Neurologic exam: • Lt. peripheral facial palsy • Dysesthesia of Rt. torso T4-T8 • Rt. mild pyramidal signs

  4. Ancillary tests • Chemistry, CBC – normal • Hypercoagulability tests – normal • HIV negative • Brain CT – normal • LP: op-160mm, prt-49.4, glu- 63(120), no cells, oligoclonal bands, VZV, WNV negative • Brain MRI - normal

  5. Follow-up • Bilateral peripheral facial palsy • Adie’s pupil

  6. Sarcoidosis • ACE-194 • Lung CT – Bilateral hilar lymphadenopathy and infiltrates (stage II)

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