Neurological complications of sarcoidosis

Purpose of review: The neurological manifestations of sarcoidosis, which occur in 5% of patients with the condition, present in a variety of ways that can be assigned to several broad categories. A comprehensive approach to the diagnosis and management of neurosarcoidosis involves an appreciation of the strategies to confirm a diagnosis of sarcoidosis and neurosarcoidosis and the available therapeutic options. Recent findings: In addition to traditional approaches to the diagnosis of sarcoidosis, positron emission tomography can be used to identify otherwise occult sites of systemic inflammation which can be targeted for biopsy. Although corticosteroids remain the mainstay of treatment, other immunosuppressive and immunomodulatory agents can be used in the multi-modality therapy of sarcoidosis. Summary: Neurosarcoidosis can be 'staged' with the use of neurodiagnostic testing and diagnosed with varying degrees of certainty. Treatment should be approached within the context of the anticipated clinical course of the patient, avoidance of adverse drug effects, and, as necessary, from the perspective of the comprehensive management of a chronic disease.