Sarcoidosis is a granulomatous disease with the potential to affect many different organ systems. Approximately 5% of patients with systemic sarcoidosis have neurological involvement.¹ Peripheral neuropathy occurs in up to 20% of these patients and is usually asymptomatic. Neurophysiological findings are consistent with primary axonal polyneuropathy.¹ We report an unusual case of neurosarcoidosis, presenting with multiple painful sensory mononeuropathies (MPSM) and progressing to a symmetric confluent sensory neuropathy.

Case report

A patient in her 4th decade of life presented with a history of multiple sensory deficits. She first developed acute onset pain and numbness of the right little finger, followed by a change in taste over the anterior two thirds of the tongue, without facial weakness. Two months later, the patient developed numbness in the palmar aspect of all fingers with dysesthesia, intermittent burning, and throbbing pain. Three months later, the pain spread to involve the dorsal aspect of the forearms. Seven months after the initial onset of symptoms, the patient developed a burning sensation in the distribution of the right sural nerve, and numbness in the right posterior leg and over the left side of the trunk. The patient denied muscle weakness, painful radicular symptoms, or systemic features.

Physical examination was remarkable for the absence …