Abstract Details

Title Clinical and Neuroimaging Features of Sarcoid Associated Myelopathy

Topic MS and Related Diseases

Presentation(s) P02 - (-)

Poster/Presentation
Number 112

Objective

Background BACKGROUND: Sarcoidosis is a systemic granulomatous disorder that frequently presents with pulmonary involvement and lymphadenopathy and occasionally may manifest with neurologic involvement including myelopathy.

Design/Methods DESIGN/METHODS: We systematically reviewed the clinical profile, neuroimaging, and CSF characteristics of 49 patients evaluated and followed at the Johns Hopkins Neuroimmunology Clinic and Transverse Myelitis Center between 2000 and 2012.

Results RESULTS: The mean age of symptom onset was 47.8 (+/- 10) years. 26 patients (53.1%) were male while 31 patients (63.3%) were African American. Myelopathy was the first manifestation of systemic sarcoidosis in 37 patients (75.5%). Most of the patients (81.63%) exhibited a chronic progressive profile in which the cervical cord appeared to be the main site of involvement in 34 patients (69.4%) while the thoracic cord was affected in 26 patients (53.1%) with a subset of patients in which there was extensive or multifocal involvement of the cervical and thoracic cord. Sensory symptoms were the first clinical complaint in 61.2% of patients. Interestingly, 24 (49%) patients presented with other associated neurological involvement, 13 with encephalitic (26.6%) and 12 with cranial neuropathic (24.4%) forms. Two myelopathic patterns were found, a tumefactive (35.4%) and a patchy multilevel pattern (32.25%), while the remainder of the patients had discrete monofocal lesions. Thirty patients (97.3%) presented with gadolinium-enhanced cord lesions during the early stage of myelopathy with 19 (62.5%) of those patients exhibiting leptomeningeal enhancement. Only 20.4% of patients were in ASIA A or B.

Conclusions CONCLUSIONS: Patients with chronic evolving tumefactive or multilevel spinal cord lesions need to be evaluated for presence of sarcoidosis and particularly those with associated meningeal or cranial nerve involvement.

Authors/Disclosures
PRESENTER	No disclosure on file
	No disclosure on file
James McGinley	James McGinley has received personal compensation for serving as an employee of Vector Psychometric Group, LLC. An immediate family member of James McGinley has received personal compensation for serving as an employee of UPMC Children's Community Pediatrics. James McGinley has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for McGinley Statistical Consulting, LLC. James McGinley has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for SAGE Cephalalgia (journal). James McGinley has stock in various companies. The institution of James McGinley has received research support from National Headache Foundation.
	No disclosure on file
Carlos A. Pardo-Villamizar, MD (Johns Hopkins U, Med Dept of Neurology)	The institution of Dr. Pardo-Villamizar has received research support from National Institutes of Health. The institution of Dr. Pardo-Villamizar has received research support from Bart McLean Fund for Neuroimmunology Research .

��ɫ��

��ɫ��