ABSTRACT
Sarcoidosis is a chronic multisystem granulomatous disease of unknown aetiology, which has a propensity to affect the lungs and rarely the nervous system; neurosarcoidosis may be an enigmatic diagnosis which is often entertained but rarely made with conviction. Prevalence rates for intrathoracic sarcoidosis vary from greater than 50 per 100, 000 e.g. in New York African-Americans, to under 10 per 100,0002. Much higher prevalence rates were obtained when consecutive postmortems were performed on approximately 60% of all deaths in an area of Sweden, of known to have sarcoidosis during life, yielding a prevalence of 641 per 100,0003. Previous data from large series of patients with sarcoidosis have estimated that approximately 5% of such patients will have clinical involvement of the nervous system4-7, although post-mortem studies suggest that ante-mortem diagnosis is only made in 50% with nervous system involvement. Therefore one can estimate that about 5 to 10 patients per million population will have clinical neurosarcoidosis. In Thailand there has been no previous report of neurosarcoidosis, thus our patient is the first documented case in the Kingdom.