In a case of neurosarcoidosis with bilateral facial nerve palsy and hy
drocephalus, contrast-enhanced magnetic resonance imaging (MRI) study
and angiotensin converting enzyme (ACE) activities in cerebrospinal fl
uid (CSF) were valuable for the diagnosis and the follow up. Facial ne
rve lesions were demonstrated on gadolinium-DTPA enhanced MRI. The dis
appearance of enhancement was concomitant with the amelioration of fac
ial nerve palsy after corticosteroid therapy.