Neurosarcoidosis

Abstract

Sarcoidosis is a multisystemic granulomatous disease, which uncommonly affects nervous system. However, when present, it may affect both central and peripheral nervous systems and potentially mimics other chronic diseases of the nervous system. Pathogenesis of neurosarcoidosis remains largely unknown, and its diagnosis and management pose serious challenges to clinicians. Early diagnosis and aggressive treatment of neurosarcoidosis are necessary to produce satisfactory clinical outcomes. This review discusses clinical manifestations, current diagnostic studies, and currently available modalities for management of neurosarcoidosis.

Vertigo as a Predominant Manifestation of Neurosarcoidosis

“…Environmental factors include infections such as Mycobacterium tuberculosis and P. acnes as well as other exposures such as pesticides, silica, or metal dusts [ 2 ]. The Th-1 response produces cytokines including interferon-gamma, interleukins 2, 6, 12, and 16 [ 4 ]. The cytokines recruit additional phagocytes and T cells, leading to the aggregation of phagocytes into epithelioid cells and giant cells.…”

“…The hallmark of sarcoidosis is the noncaseating granuloma, which consists of activated macrophages and CD4-helper T lymphocytes [ 2 ]. Granulomas are the source of ACE, which is found to be elevated in some cases [ 4 ].…”

Ace the case: a 14-year-old with lower extremity weakness and blurry vision

“…Neurosarcoidosis occurs in 5%–10% of patients with systemic sarcoidosis 1. Cranial neuropathies are the most common and a classic manifestation of neurosarcoidosis.…”

Sarcoïdose osseuse : étude rétrospective de 27 cas

“…L'atteinte méningée est notée dans 8 à 64% des cas de neurosarcoïdose (196)(197)(198). Il s'agit souvent d'une méningite asymptomatique chronique.…”

“…Les biopsies méningées peuvent être nécessaires et sont alors guidées par l'imagerie (204). L'atteinte du SNC est notée dans 36 à 66% des cas (196)(197)(198). Les troubles psychiques sont les plus fréquents (9 à 48% des cas) allant de l'état euphorique au tableau de démence (196,198,205).…”