Abstract
Neurosarcoidosis is an uncommon but potentially serious manifestation of sarcoidosis. While the cranial nerves are most frequently affected, neurosarcoidosis can involve other nervous system tissues including the meninges, brain parenchyma (especially the hypothalamic region), spinal cord, peripheral nerve, and muscle. Diagnosis may be particularly challenging when neurosarcoidosis occurs in isolation. Diagnostic criteria usually include histologic identification of a noncaseating granuloma, supportive laboratory or imaging tests or both, and a compatible clinical course. Treatment has not been subjected to rigorous study, but corticosteroids are typically the first line of therapy and approximately half of patients have substantial benefit. For patients who are refractory to or intolerant of corticosteroid therapy, second-line agents include azathioprine, methotrexate, cyclosporine, cyclophosphamide, mycophenolate, and even cranial irradiation. The combination of infliximab and mycophenolate mofetil is under study as well. Treatment options will likely evolve as well-designed studies are undertaken.
Keywords: Neurosarcoidosis, sarcoidosis, cranial neuropathy, meningitis, neuroendocrine dysfunction, seizures, peripheral neuropathy, myopathy
Current Neuropharmacology
Title: Neurosarcoidosis
Volume: 9 Issue: 3
Author(s): David Lacomis
Affiliation:
Keywords: Neurosarcoidosis, sarcoidosis, cranial neuropathy, meningitis, neuroendocrine dysfunction, seizures, peripheral neuropathy, myopathy
Abstract: Neurosarcoidosis is an uncommon but potentially serious manifestation of sarcoidosis. While the cranial nerves are most frequently affected, neurosarcoidosis can involve other nervous system tissues including the meninges, brain parenchyma (especially the hypothalamic region), spinal cord, peripheral nerve, and muscle. Diagnosis may be particularly challenging when neurosarcoidosis occurs in isolation. Diagnostic criteria usually include histologic identification of a noncaseating granuloma, supportive laboratory or imaging tests or both, and a compatible clinical course. Treatment has not been subjected to rigorous study, but corticosteroids are typically the first line of therapy and approximately half of patients have substantial benefit. For patients who are refractory to or intolerant of corticosteroid therapy, second-line agents include azathioprine, methotrexate, cyclosporine, cyclophosphamide, mycophenolate, and even cranial irradiation. The combination of infliximab and mycophenolate mofetil is under study as well. Treatment options will likely evolve as well-designed studies are undertaken.
Export Options
About this article
Cite this article as:
Lacomis David, Neurosarcoidosis, Current Neuropharmacology 2011; 9 (3) . https://dx.doi.org/10.2174/157015911796557975
DOI https://dx.doi.org/10.2174/157015911796557975 |
Print ISSN 1570-159X |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6190 |
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
- Forthcoming Thematic Issues
Related Articles
-
Potential Prophylactic and Therapeutic Vaccines for HSV Infections
Current Pharmaceutical Design Immunomodulatory Properties of Antibiotics
Current Molecular Pharmacology Nuclear Imaging of Inflammation in Neurologic and Psychiatric Disorders
Current Clinical Pharmacology Brain Permeable Nanoparticles
Recent Patents on CNS Drug Discovery (Discontinued) Mouse ATP-Binding Cassette (ABC) Transporters Conferring Multi-Drug Resistance
Anti-Cancer Agents in Medicinal Chemistry Recent Trends in Antifungal Agents: A Reference to Formulation, Characterization and Applications
Drug Delivery Letters Uropathogenic Escherichia coli Mediated Urinary Tract Infection
Current Drug Targets Cytomegalovirus Infections in Non-Immunocompromised and Immunocompromised Patients in the Intensive Care Unit
Infectious Disorders - Drug Targets The Ambivalent Role of Apoptosis in Experimental Autoimmune Encephalomyelitis and Multiple Sclerosis
Current Pharmaceutical Design Evaluation of Small Molecule Tuberculostats for Targeting Tuberculosis Infections of the Central Nervous System
Central Nervous System Agents in Medicinal Chemistry Drug Discovery in Enteroviral Infections
Infectious Disorders - Drug Targets Role of the Bacterial Type VI Secretion System in the Modulation of Mammalian Host Cell Immunity
Current Medicinal Chemistry Hypersensitivity Reactions to Last Generation Chimeric, Umanized and Human Recombinant Monoclonal Antibodies for Therapeutic Use
Current Pharmaceutical Design Intestinal Barrier Dysfunction Participates in the Pathophysiology of Ischemic Stroke
CNS & Neurological Disorders - Drug Targets Structural Vaccinology: A Three-dimensional View for Vaccine Development
Current Topics in Medicinal Chemistry Clear Shot at Primary Aim: Susceptibility of Trypanosoma cruzi Organelles, Structures and Molecular Targets to Drug Treatment
Current Topics in Medicinal Chemistry Neuroimmune Crosstalk in CNS Disorders: The Histamine Connection
Current Pharmaceutical Design Proinflammatory Cytokines and Chemokines in Neonatal Brain Damage
Current Pediatric Reviews Intravenous Immunoglobulin Preparations and Autoimmune Disorders: Mechanisms of Action
Current Pharmaceutical Biotechnology Activin-A: A New Piece in the Puzzle of Tolerance in Asthma
Clinical Anti-Inflammatory & Anti-Allergy Drugs (Discontinued)