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Subject: Re: Neurosarcoidosis
Forum: The Neurology and Neurosurgery Forum
Topic Area:
Posted by CCF NEURO MD on April 25, 1997 at 15:59:06:
In Reply to: Neurosarcoidosis posted by Ritkit on April 16, 1997 at 09:27:31:
: Subject:
NEUROSARCOIDOSIS
PLEASE SEND INFORMATION REGARDING NEUROSARCOIDOSIS. I AM A BSN PRIMARY CARE
NURSE FOR A HOMECARE NURSING AGENCY CARING FOR A SIXTEEN YEAR OLD FEMALE WITH
THIS DIAGNOSIS. SHE IS ON PREDNISONE, HALDOL, ATIVAN, MORPHINE, CYCLOSPORIN,
VASOTEC, ZANTAC, AND SEVERAL OTHER MEDS. SHE HAS GENERALIZED BODY EDEMA
(PREDNISONE RELATED I BELIEVE), ABSENT GAG REFLEX AND UNABLE TO STAND OR HOLD
HER WEIGHT WHEN STANDING. PLEASE SEND ANY INFORMATION AVAILABLE ON THIS
CONDITION. I NEED INFORMATION TO HELP IN OUR CARE OF HER. RITKIT
=Hello Ritkit, Neurosarcoidosis is a disease of uncertain cause. When looking at brain tissue affected by sacroidosis, it superficially resembles an infection of the brain like that caused by tuberculosis, although an infectious agent has never been found in patients with neurosacroidosis. When the central nervous system is involved by sacroidosis it can affect the covering of the brain (meninges), the brain substance itself, the spinal cord, and also nerves. Because it can affect differents parts of the brain, it can cause many different types of symptoms. Some of the complains patients can have include headache, facial weakness, numbness of hands or feet, weakness, unsteadiness etc. The diagnosis is made by the clinical presentation, radiographic features, and biopsy of tissue. Steriods such as prednisone is the first line treatment of this process. Various other immunosuppresive treatment can also be tried. Radiation therapy is used in advanced cases. This can be a very difficult problem to treat.
In addition to the primary treatment modalities mentioned, skilled nursing care to prevent bed sores, pneumonia, blood clots in the legs etc. are very important in the patient who is not able to walk and is bedridden. Physical therapy and occupational therapy can be heplful for preventing contractures and helping with issues involved in activities of daily living. A speech therapist can be helpful in suggesting what type of food the patient can handle in order to avoid pneumonias resulting from food going down the wrong pipe and into the lungs. This is espicially important in pateints with an absent gag refelex. Any noticable new or worsening symptom should be communicated to the treating neurologist as this may prompt a change in the treatment plan. I hope you find this information useful.
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