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Relapsing encephalopathy with headache: an unusual presentation of isolated intracranial neurosarcoidosis

¹ Department of Neurology, Flinders Medical Centre, Adelaide, Australia
² Department of Immunology, Allergy and Arthritis, Flinders Medical Centre, Adelaide, Australia
³ Department of Neurology, Flinders Medical Centre, Adelaide, Australia

Correspondence to:
Correspondence to:
Robert A Wilcox
Department of Neurology, Level 2, Flinders Medical Centre, Bedford Park, Adelaide, 5042, Australia; Robert.Wilcox@fmc.sa.gov.au

The first 150 words of the full text of this article appear below.

We report a presentation of relapsing and remitting isolated intracranial neurosarcoidosis in a female patient who presented with episodic severe headache and behavioural disturbance initially misdiagnosed as psychosis. Eventually, several episodes were accompanied by visual disturbance secondary to papilloedema, ultimately leading to a diagnosis of neurosarcoidosis on meningeal biopsy.

Sarcoidosis is a multisystem inflammatory disease of unknown aetiology, and is characterised by non-caseating granulomata. Pulmonary disease is the most common manifestation, occurring in 90% of patients. Clinical involvement of the nervous system is said to occur in 5–15% of patients.¹ Isolated intracranial neurosarcoidosis is even rarer, with systemic sarcoidosis being detected in more than 95% of cases of sarcoidosis initially presenting with neurological symptoms.²

Case report
A woman presented initially at age 30 years, and then subsequently five times over 3 years with stereotyped episodes of headache, confusion and psychomotor agitation. In each instance, a history was given of a constant, severe . . . [Full text of this article]