The Proof’s in the Pudding: Case of Cauda Equina due to Known Sarcoid

A 35-year-old Caucasian male with a history of hepatic sarcoidosis presented to the neurology clinic with 1 month of right hip flexor weakness and perianal/lateral thigh numbness. The patient had normal bowel and bladder functions, but could not experience the emptying sensations. He was physically active prior to symptom onset, and denied any trauma or inciting factors. Motor exam was notable for 4+ strength of his right hip flexor, hamstring, and foot dorsiflexion. Sensory exam revealed decreased sensation to pinprick, light touch, and vibration of the right foot and toes.