TY - JOUR T1 - Autonomic dysreflexia due to neurogenic bladder dysfunction; an unusual presentation of spinal cord sarcoidosis JF - Journal of Neurology, Neurosurgery & Psychiatry JO - J Neurol Neurosurg Psychiatry SP - 819 LP - 820 DO - 10.1136/jnnp.71.6.819 VL - 71 IS - 6 AU - R SAKAKIBARA AU - T UCHIYAMA AU - S KUWABARA AU - N KAWAGUCHI AU - I NEMOTO AU - M NAKATA AU - T HATTORI Y1 - 2001/12/01 UR - http://jnnp.bmj.com/content/71/6/819.abstract N2 - Clinical involvement of the CNS in sarcoidosis is seen in about 5% of patients.1 The most common affected sites are the basal leptomeninges and the region of the floor of the third ventricle. However, primary involvement of the spinal cord is much less common.1 It may cause serious neurological deficits below the affected level of the lesion. Here we describe a case of spinal cord sarcoidosis with an unusual presentation: autonomic dysreflexia due to neurogenic bladder dysfunction.A 42 year old woman began to have a slowly progressive spastic gait, left hand numbness, urinary urgency/frequency, and voiding difficulty which worsened gradually for a year. She underwent C2–7 laminoplasty for a relief of C4–6 cervical disc herniation where mild cord swelling was present. However, her gait difficulty ameliorated only for 2 weeks. Two months later she became unable to walk without an aid. Spinal MRI disclosed C2–7 cord swelling. She also developed bilateral hilar lymphadenopathy, ocular uveitis, and an increased serum concentration of angiotensin converting enzyme (ACE). Endoscopic lymph node biopsy showed non-caseating epithelioid granuloma. These findings and the clinical features confirmed the diagnosis of spinal cord sarcoidosis. She underwent steroid pulse therapy (1000 mg/day of intravenous methylprednisolone over 3 succeeding days) and started taking oral prednisolone (60 mg/day) with benefit. Steroids were tapered to 40 mg every other day and 4 months later she was referred to our hospital. However, her gait difficulty … ER -