Crisis epiléptica como primera manifestación de sarcoidosis: Caso clínico

• CRISTINA LIDIA FERNÁNDEZ-REY ^[1] ; ANTONIO SAIZ AYALA ^[1] ; MARÍA JESÚS ÁLVAREZ-URÍA TEJERO ^[1] ; ELENA SANTAMARTA LIÉBANA ^[1] ; SERAFÍN COSTILLA GARCÍA ^[1]
  1. [1] Hospital Universitario Central de Asturias

     Hospital Universitario Central de Asturias

     Oviedo, España

     
• Localización: Revista Médica de Chile, ISSN-e 0034-9887, Vol. 138, Nº. 4, 2010, págs. 473-477
• Idioma: español
• Títulos paralelos:
  • Sarcoidosis presenting as partial seizures: Report of one case
• Enlaces
  • Texto completo
• Resumen

  • The nervous system is affected in 10% of patients with sarcoidosis. However, neurological disturbances are rarely the frst manifestation of the disease. We report a 36-year-old woman presenting with partial seizures that generalized secondarily. Magnetic resonance showed a left parietal cortical-subcortical lesion with a minimal mass effect, moderate vasogenic edema and intense enhancement with intravenous contrast. A magnetic resonance spectroscopy disclosed a low aggressiveness profle, compatible with an infammatory lesion. Angiotensin converting enzyme levels were normal. The lesion was excised and the pathological study showed the presence of granulomas with dubious necrosis. The patient was treated with antituberculous drugs. One year later, the lesion had grown and a thorax CT scan showed numerous mediastinal and hilar lymphadenopathies. A new determination of angiotensin converting enzyme disclosed elevated levels and the biopsy of mediastinal lymph nodes confrmed the presence of sarcoidosis.