REVIEW PAPER
Neurosarcoidosis
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Submission date: 2014-02-01
Acceptance date: 2014-02-24
Publication date: 2014-04-01
Medical Studies 2014;30(1):51-56
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ABSTRACT
Sarcoidosis is a multi-organ granulomatous disease of unknown aetiology. Although it usually affects lungs and hilar lymph nodes, lesions can also affect other organs, including the organs of the nervous system. Five–fifteen percent of sarcoidosis patients are diagnosed with diverse neurological symptoms, in most cases the cranial nerves and meninges. Parenchymal lesions in the cerebrum, spinal cord, peripheral nerves and muscles are less common. Such a complex symtomatology causes numerous diagnostic problems, especially in cases beginning with neurological symptoms. The diagnosis of neurosarcoidosis is based on clinical signs, radiological techniques, examination of cerebrospinal fluid and histopathological examination confirming the presence of non-caseating granulomas. The treatment in neurosarcoidosis is difficult and depends on the manifestation of the disease. Adrenal corticosteroids are commonly used.
REFERENCES (39)
1.
Iannuzzi MC, Rybicki BA, Teirstein AS. Sarcoidosis. N Engl J Med 2007; 357: 2153-2165.
2.
Nunes H, Bouvry D, Soler P, et al. Sarcoidosis. Orphanet J Rare Dis 2007; 19: 46.
3.
Płodziszewska M, Wiatr E. Sarkoidoza. In: Choroby śródmiąższowe płuc. Wiatr E, Rowińska-Zakrzewska E, Pirożyński M. Alfa Medica Press, Bielsko-Biała 2012; 111-123.
4.
Sharma OP. Sarcoidosis around the world. Clin Chest Med 2008; 29: 357-363.
5.
Rybicki BA, Iannuzzi MC. Epidemiology of sarcoidosis: recent advances and future prospects. Semin Respir Crit Care Med 2007; 28: 22-35.
6.
Pacholska-Pytlakowska M, Płusa T, From S. Współczesne uwarunkowania etiopatogenetyczne sarkoidozy. Pol Merk Lek 2011; 31: 288-291.
7.
Voorter CE, Drent M, Hoitsma E, et al. Association of HLA DQB1 0602 in sarcoidosis patients with small fiber neuropathy. Sarcoidosis Vasc Diffuse Lung Dis 2005; 22: 129-132.
8.
Drozdowski W. Neurosarkoidoza – problemy diagnostyczne i terapeutyczne. Pol Przegl Neurol 2010; 6 (supl. A): 57-59.
9.
Hoitsma E, Faber CG, Drent M, et al. Neurosarcoidosis: a clinical dilemma. Lancet Neurol 2004; 3: 397-407.
10.
Stern BJ, Krumholz A, Johns C, et al. Sarcoidosis and its neurological manifestations. Arch Neurol 1985; 42: 909-917.
11.
Lacomis D. Neurosarcoidosis. Curr Neuropharmacol 2011; 9: 429-436.
12.
Borratyńska A, Zwolińska G, Turaj W, et al. Neurosarkoidoza i ból. Neur Neurochir Pol 2008; 42: 69-74.
13.
Gaweł M, Domitrz I, Dziewulska D, Dąbrowski A. Objawy psychotyczne i poznawcze w przebiegu neurosarkoidozy. Psych Pol 2012; 46: 1099-1108.
14.
Nowak DA, Widenka DC. Neurosarcoidosis: a review of its intracranial manifestation. J Neurol 2001; 248: 363-372.
15.
Brouwer MC, de Gans J, Willemse RB. Sarcoidosis presenting as hydrocephalus. J Neurol Neurosurg Psychiatry 2009; 80: 550-551.
16.
Pickuth D, Heywang-Köbrunner SH. Neurosarcoidosis: evaluation with MRI. J Neuroradiol 2000; 27: 185-188.
17.
Smith JK, Matheus MG, Castillo M. Imaging manifestations of neurosarcoidosis. AJR Am J Roentgenol 2004; 182: 289-295.
18.
Spiegel DR, Morris K, Rayamajhi U. Neurosarcoidosis and the complexity in its differential diagnoses: a review. Innov Clin Neurosci 2012; 9: 10-16.
19.
Pawate S, Moses H, Sriram S. Presentation and outcomes of neurosarcoidosis: a study of 54 cases. QJM 2009; 102: 449-460.
20.
. Jain V, Deshmukh A, Gollomp S. Bilateral facial paralysis: case presentation and discussion of differential diagnosis. J Gen Intern Med 2006; 21: 7-10.
21.
Joseph FG, Scolding NJ. Neurosarcoidosis: a study of 30 new cases. J Neurol Neurosurg Psychiatry 2009; 80: 297-304.
22.
Jamrozik Z, Dąbrowski A, Drac H. Neurosarkoidoza czy zespół Guillain-Barre w przebiegu sarkoidozy. Neur Neurochir Pol 1996; 3: 481-487.
23.
Miller R, Sheron N, Semple S. Sarcoidosis presenting with an acute Guillain-Barré syndrome. Postgrad Med J 1989; 65: 765-767.
24.
Vinas FC, Rengachary S. Diagnosis and management of neurosarcoidosis. J Clin Neuroscience 2001; 8: 505-513.
25.
Lower E, Broderick J, Brott T. Diagnosis and management of neurological sarcoidosis. Arch Intern Med 1997; 157: 1864-1868.
26.
Judson MA. The diagnosis of sarcoidosis. Clin Chest Med 2008; 29: 415-427.
27.
Zajicek JP, Scolding NJ, Foster O. Central nervous system sarcoidosis – diagnosis and management. QJM 1999; 92: 103-117.
28.
Tahmoush AL, Amir MS, Connor WW, et at. CSF-ACE activity in probable neurosarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis 2002; 19: 191-197.
29.
Jones DB, Mitchell D, Horn DB, Edwards CRW. Cerebrospinal fluid angiotensin-converting enzyme levels in the diagnosis of neurosarcoidosis. Scot Med J 1991; 36: 144-145.
30.
Juozevicius JL, Rynes RI. Increased helper/suppresser T-lymphocyte ratio in the cerebrospinal fluid of a patient with neurosarcoidosis. Ann Intern Med 1986; 104: 807-808.
31.
Stern BJ, Griffin DE, Luke RA, et al. Neurosarcoidosis: cerebrospinal fluid lymphocyte subpopulations. Neurology l987; 37: 878-881.
32.
Kantrow S, Mayer K, Kidal P, et al. The GD4/GD8 ratio in BAL fluid is highly variable in sarcoidosis. Eur Resp J 1997; 10: 2716-2721.
33.
Baughman RP, Costabel U, du Bois RM. Treatment of sarcoidosis. Clin Chest Med 2008; 29: 533–548.
34.
Baughman RP, Ohmichi M, Lower EE. Combination therapy for sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis 2002; 18: 133-137.
35.
Agbogu BN, Stern BJ, Sewell C, Yang G. Therapeutic considerations in patients with refractory neurosarcoidosis. Arch Neurol 1995; 52: 875-879.
36.
Scott TF, Yandora K, Valeri A, et al. Aggressive therapy for neurosarcoidosis: long-term follow-up of 48 treated patients. Arch Neurol 2007; 64: 691-696.
37.
Soriano FG, Caramelli P, Nitrini R, Rocha AS. Neurosarcoidosis: therapeutic success with methotrexate. Postgrad Med J 1990; 66: 142-143.
38.
Stern BJ, Schonfeld SA, Sewell C, et al. The treatment of neurosarcoidosis with cyclosporine. Arch Neurol 1992; 49: 1065-1072.
39.
Polman CH, Reingold SC, Banwell B, et al. Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald Criteria. Ann Neurol 2011; 69: 292-302.