Sarcoidosis of the peripheral nervous system.

Neurological manifestations of sarcoidosis are relatively rare but constitute a treatable cause of central and peripheral neurological manifestations. Regarding the peripheral nervous system, cranial nerves are predominantly affected, and peripheral facial nerve palsy, often bilateral, is the most common neurological manifestation of sarcoidosis. Multifocal peripheral neuropathy is a rare event in sarcoidosis. In some cases, however, peripheral neuropathy is the presenting manifestation and seemingly the only organ affected. Definite diagnosis of sarcoidosis rests ideally on histological demonstration of sarcoid granulomas in tissue biopsy specimens.

Said G 《-》

Neuro-ophthalmic sarcoidosis: the University of Iowa experience.

Koczman JJ ，Rouleau J ，Gaunt M ，Kardon RH ，Wall M ，Lee AG ... -  《Seminars in Ophthalmology》

Sarcoidosis and the Nervous System.

Pawate S 《-》

Neurosarcoidosis: report of 30 cases and a literature survey.

Neurosarcoidosis accounts for approximately 5% of cases of sarcoidosis. To determine the frequency of Neurosarcoidosis in our setting and analyze the clinical-radiological findings and evolution of 30 patients consecutively diagnosed. The medical records of patients with a diagnosis of Neurosarcoidosis were reviewed, and data regarding the clinical features, ancillary tests performed, treatment, and outcome were recorded. We revised the literature to summarize and discuss the previous clinical series of Neurosarcoidosis. It accounted for 6.7% of all cases of sarcoidosis. Seven patients had definite diagnosis and 23 had probable diagnosis. The mean age at onset of Neurosarcoidosis was 48.3 years and 66.7% of patients were women. Neurologic clinical features were the first manifestation of Neurosarcoidosis in 70% of cases. Cranial neuropathy was present in 17 patients and 14 of them had facial palsy. The central nervous system was affected in 10 patients and the peripheral nervous system in 5. Chest disease, the most common extraneurologic manifestation, was present in 20 patients. All patients were treated with corticosteroids, and all those with central nervous system involvement had poor outcome. Neurosarcoidosis requires a high degree of suspicion to establish the diagnosis. Central nervous system involvement is associated with a poor prognosis.

Gascón-Bayarri J ，Mañá J ，Martínez-Yélamos S ，Murillo O ，Reñé R ，Rubio F ... -  《-》

Neurosarcoidosis: diagnosis and management.

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.

Vargas DL ，Stern BJ 《-》