Presentations and outcomes of neurosarcoidosis: a study of 54 cases

Abstract

Unlike systemic sarcoidosis, there is difficulty in making tissue diagnosis when involvement of CNS is suspected. MRI and CSF studies are sensitive in the detection of CNS inflammation but lack specificity, making the ascertainment of neurosarcoidosis a clinical challenge. In addition the low prevalence of the disease makes clinical trials difficult and therapeutic decisions are likely to be made from careful reporting from case studies.

Acute inflammatory myelopathies

“…A recent case series of neurosarcoidosis from Vanderbilt University found that 10/54 (19%) patients had a clinical myelopathy and 13/54 (24%) had radiographic evidence of spinal cord involvement on MRI (Pawate et al, 2009). Only 1 patient had radiographic involvement restricted to the spinal cord.…”

Immune Mediated Diseases and Immune Modulation in the Neurocritical Care Unit

“…Tuberculosis should always be in the differential for sarcoid and must always be considered prior to institution of immunomodulatory therapy. Somewhere between 5% and 15% of patients with sarcoid will develop neurological complications, and the estimated incidence of neurosarcoid is approximately 10 per million of the population [179,180]. In most patients with neurosarcoid, the neurological disease is the presenting manifestation of sarcoid [179][180][181].…”

“…Somewhere between 5% and 15% of patients with sarcoid will develop neurological complications, and the estimated incidence of neurosarcoid is approximately 10 per million of the population [179,180]. In most patients with neurosarcoid, the neurological disease is the presenting manifestation of sarcoid [179][180][181]. The neurological involvement can take the form of distal symmetric neuropathy and mononeuritis multiplex to basilar meningitis, granulomatous mass lesions, seizures, and endocrine dysfunction.…”

“…Headaches and visual complaints are the most common presenting symptoms [180]. Cranial neuropathies occur in up to 75% of patients and most commonly involve the optic nerve, although involvement of the facial nerve is considered classic [179,180,182]. Endocrine abnormalities are common in sarcoid and are related to the fact that it tends to involve the hypothalamus and pituitary [183].…”

Brain MRI Depiction of Multiple Cranial Neuropathies in Neurosarcoidosis: A Case Report

“…Cranial neuropathy is the common manifestation in neurosarcoidosis [1,2]. Multiple cranial neuropathies involving 4 or more kinds of the cranial nerves were reported in a few patients with neurosarcoidosis [3,4].…”