Neurosarcoidosis: Diagnosis and management

Diana L. Vargas, Barney J. Stern

Research output: Contribution to journalReview articlepeer-review

Abstract

Sarcoidosis is a multisystemic inflammatory granulomatous disease that affects both the central and peripheral nervous system. The neurological manifestations depend on the areas of the neuroaxis affected. In the brain, patients with neurosarcoidosis have leptomeningeal and intraparenchymal infiltration of granulomas that leads to, for example, cranial nerve palsies, basal meningitis, and endocrine dysfunction. It can cause peripheral neuropathies such as mononeuritis multiplex and sensorimotor polyneuropathy as well as radiculopathy and myopathy. Diagnosis and management of patients with neurosarcoidosis are challenging given that the gold standard is tissue-proven biopsy, which, in most cases of neurological illness, is difficult to obtain. Treatment strategies have not been rigorously evaluated but corticosteroids are considered the drug of choice. Other immunosuppressant agents such as cyclophosphamide, mycophenolate mofetil, and infliximab are efficacious in the treatment of neurosarcoidosis.

Original languageEnglish (US)
Pages (from-to)419-427
Number of pages9
JournalSeminars in Respiratory and Critical Care Medicine
Volume31
Issue number4
DOIs
StatePublished - Aug 3 2010
Externally publishedYes

Keywords

  • Neurosarcoidosis
  • immunosuppression
  • inflammation

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

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