A case of sarcoidosis presenting ataxic hemiparesis as an initial clinical manifestation

: A case of sarcoidosis presenting ataxic hemiparesis was reported. A 25-year-old man was admitted to Kanto Teishin Hospital because of slight weakness and dysesthesia in the right side of his body. His physical findings were normal. Neurological findings disclosed mild right hemiparesis (MMT 4+), cerebellar signs and mild dysesthesia in the same side. Laboratory findings were within normal limits except for elevated serum ACE and lysozyme. Chest roentgenogram showed bilateral hilar lymphadenopathy and TBLB disclosed sarcoid granuloma. Though brain CT, brain MRI and cerebral angiography were within normal limits, the neurological features were thought to be due to sarcoidosis. They disappeared along with the decrease of ACE and lysozyme. This is the first report of ataxic hemiparesis due to sarcoidosis, and it is interesting in that ataxic hemiparesis, which is one of signs of diseases in central nervous system, is the first manifest clinical feature of sarcoidosis.