A young 27-year-old healthy Nigerian origin man presented with an acute confusion and agitation. His medical history didn’t show any trauma, fever or weakness, he lives in UK with no contact with TB patient. He had a history of inflammatory arthritis. All his investigations were normal, His CSF examination showed protein cells. In addition, he had an EEG which was revealed Bi frontal dysfunction with no ictal patterns. His imaging, the MRI/MRA brain showed thin nodular leptomeningeal inflammatory disease and isolated left pontine micro haemorrhage consistent with Neurosarcoidosis and no features of infarction or vasculitis. He was commenced on high dose of steroids while he was in acute medical department and continued for five days. He was improved dramatically on subsequent days and discharged in a good condition.
Neurosarcoidosis is very rare disease that affects 5% of all patients and it will be fatal if not treated. Nonetheless, provided with expert care.
Mai Omer Ibrahim* and Einas Khalifa