Management of neurosarcoidosis: a clinical challenge

Mareye Voortman, Marjolein Drent*, Robert P. Baughman

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review

32 Citations (Web of Science)

Abstract

Purpose of review

Sarcoidosis is a complex disease with many faces, and the clinical manifestation and course of neurosarcoidosis are particularly variable. Although neurosarcoidosis occurs in up to 10% of sarcoidosis patients, it can lead to significant morbidity and some mortality.

Recent findings

Three criteria are usually required for a diagnosis of (neuro) sarcoidosis: clinical and radiologic manifestations, noncaseating granulomas, and no evidence of alternative disease. Recent guidelines have helped to clarify criteria for diagnosing neurosarcoidosis. No firm guidelines exist on whether, when, and how treatment should be started. Treatment depends on the presentation and distribution, extensiveness, and severity of neurosarcoidosis. As regards evidence-based treatment, only a few randomized controlled trials have been done. Hence, several aspects of (neuro) sarcoidosis management are not fully addressed by the current literature.

Summary

Significant advances have been made in the potential and accuracy of diagnostics for neurosarcoidosis. Treatment should be approached within the context of the patient's anticipated clinical course, avoidance of adverse drug effects, and, if necessary, from the perspective of the comprehensive management of a chronic disease. A multidisciplinary approach to the management of sarcoidosis is strongly recommended.

Original languageEnglish
Pages (from-to)475-483
Number of pages9
JournalCurrent Opinion in Neurology
Volume32
Issue number3
DOIs
Publication statusPublished - Jun 2019

Keywords

  • CNS SARCOIDOSIS
  • CORNEAL CONFOCAL MICROSCOPY
  • DIAGNOSIS
  • INFLIXIMAB THERAPY
  • LEFLUNOMIDE
  • NEEDLE-ASPIRATION
  • PULMONARY
  • SARCOIDOSIS PATIENTS
  • SEVERITY
  • SMALL FIBER NEUROPATHY
  • diagnostic procedure
  • infliximab
  • multidisciplinary management
  • neurosarcoidosis
  • sarcoidosis
  • treatment
  • EVERYDAY COGNITIVE FAILURE

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