Sarcoidosis of the brain and spinal cord.

THE dermatological lesions of sarcoidosit were first described by Boeck in I899, and in 1905 Winkler reported the manifestations of this disease in the nervous system (cited by Salvesen), while others at about the same time described involvement of other organs by sarcoid tissue. Among 20 cases of sarcoidosis at autopsy, Aszkanazy (1952) found three to have central nervous system lesions. However, L6fgren (personal communication with Hook) (I955) stated that he found clinical evidence of central nervous system involvement in only two of 300 cases of sarcoidosis, that is, under i per cent., but his cases were mostly in the primary stages of the disease. Carstensen and Norviit (I953) in I5 cases of sarcoidosis, found increased protein and a pleocytosis in the cerebrospinal fluid in six cases, although only two of. these cases had signs of central nervous system involvement, indicating that it may be more common than is generally supposed, and may be easily missed if the cerebrospinal fluid is not examined. Colover (1948) surveyed I15 cases of sarcoidosis affecting the nervous system found in the literature, adding three cases of his own. The lesions in these i I8 cases were: (a) Cranial nerve lesions; anosmia (2); ptosis (6) and other oculomotor lesions (3); sluggish pupil responses without active iritis (3); trigeminal impairment or loss (5); facial paralysis (58, of which 22 were bilateral); nerve deafness (8) and disturbance of vestibular branch of acoustic nerve (4); dysphagia, or vocal cord paralysis (38) and twelfth nerve lesions (7). (b) Peripheral nerve lesions (localized) (i). (c) Intra-ocular lesions (33). (d) Pituitary and hypothalamic lesions (22). (e) Meningeal involvement (9). (f) Spinal cord and brain lesions (I3). Jefferson (1957) reviewed the literature and recorded seven cases of his own, illustrating the