NEUROSARCOIDOSIS OF THE CONUS MEDULLARIS AND CAUDA-EQUINA PRESENTING AS PARAPARESIS - CASE-REPORT AND LITERATURE-REVIEW

Sarcoidosis is a multi-system, non-caseating granulomatous disease of unknown etiology. Although spinal cord involvement is rare, it may cau se severe neurological complications. We report the case of a 52-year- old woman who developed low back pain and a progressive flaccid parapa resis whose investigations revealed pulmonary and spinal sarcoidosis. To our knowledge, this is the first reported case of sarcoidosis of th e conus medullaris and cauda equina diagnosed by an unusual enhancemen t pattern observed on magnetic resonance imaging with gadolinium. Biop sy of the lumbar nerve roots and of the lung revealed a non-caseating granuloma. Treatment with steroids and intensive rehabilitation result ed in remarkable functional improvement. Although rare, sarcoidosis of the conus medullaris and cauda equina should be considered in the dif ferential diagnosis of flaccid paraparesis, particularly in patients w ith non-diagnostic evaluations.