Semin Respir Crit Care Med 2017; 38(04): 499-513
DOI: 10.1055/s-0037-1604165
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Neurosarcoidosis

Daniel A. Culver1, Manuel L. Ribeiro Neto1, Brandon P. Moss2, Mary A. Willis2
  • 1Department of Pulmonary Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, Ohio
  • 2Neurologic Institute, Cleveland Clinic, Cleveland, Ohio
Further Information

Publication History

Publication Date:
27 July 2017 (online)

Abstract

Neurosarcoidosis is an uncommon but clinically significant manifestation that will be routinely encountered in sarcoidosis specialty clinics. Overall, neurologic involvement is recognized in 5 to 10% of individuals with sarcoidosis. Neurologic symptoms will be the presenting manifestation of sarcoidosis in approximately one-half of those with neurosarcoidosis. The clinical and imaging features of neurosarcoidosis vary widely, largely depending on the anatomic distribution of the disease. The likelihood of spontaneous resolution is lower than for sarcoidosis in general, and residual functional deficits are not uncommon. Therefore, most patients with neurosarcoidosis require immunosuppressive therapy. Small fiber neuropathy, a recently recognized nongranulomatous parasarcoidosis syndrome, is prevalent in chronic sarcoidosis. The variety of neurologic manifestations, broad differential diagnosis, and complexity of management render neurosarcoidosis an area best served by multidisciplinary teams. Sarcoidologists, neurologists, radiologists, neurosurgeons, endocrinologists, urologists, physiatrists, and physical/occupational therapists all potentially have important roles.