Neurosarcoidosis: unusual presentations and considerations for diagnosis and management

Abstract

Background Sarcoidosis is a chronic, multisystem disease characterised by non-necrotising granulomatous inflammation of unknown aetiology. Most commonly, the lungs, lymph nodes, skin and eyes are affected in sarcoidosis; however, nervous system involvement occurs in approximately 5%–15% of cases. Any part of the nervous system can be affected by sarcoidosis. Cases Herein we describe three unusual patient presentations of neurosarcoidosis, one with optic neuritis, a second with hydrocephalus and a third with cervical myelopathy. Conclusions We include pertinent details about their presentations, imaging findings, pathology, management and clinical course.

<p>Intramedullary spinal cord involvement: a rare presentation of sarcoidosis</p>

“…In the majority of case reports in the literature, sarcoidosis occurs between 20 and 45 years of age; however, in more recent studies, the peak age was reported to be close to 30–55 years old 6. Women are more commonly affected than men 7. Sarcoidosis most commonly affects cranial nerves, with the seventh nerve, followed by the second nerve, being mostly frequently involved 4.…”

Primary CNS Lymphomas: Challenges in Diagnosis and Monitoring

“…Magnetic resonance imaging findings are variable. About 40% of patients with neurosarcoidosis have either leptomeningeal enhancement or multiple white matter enhancing lesions [ 63 ]. In these cases, differential diagnosis should be based on serum ACE levels, CSF examination (usually with pleocytosis, increased protein level, and oligoclonal bands), chest high-resolution CT (HRCT), and bronchoalveolar lavage (BAL).…”

A Quick and Comprehensive Guide to Differential Diagnosis of Neck and Back Pain: a Narrative Review

“…Clinically, neck or back pain with various neurological problems is observed. Cervical involvement is more common than thoracic or lumbar involvement [45]. Torticollis is involuntary contraction of neck muscles (dystonia), usually the sternocleidomastoid.…”