Neurosarcoidosis: signs, course and treatment in 35 confirmed cases.
Thirty-five cases of biopsy-proven sarcoidosis with neurologic manifestations are reported. Neurosarcoidosis was the presenting symptom in 31% of cases and the only clinical manifestation in 17%. Mean follow-up time was 48 months. Central nervous system involvement was observed in 37% and meningitis in 40% of patients. Other manifestations were cranial nerve palsies (37%), peripheral neuropathy (40%), and myopathy (26%). Multiple neurologic manifestations were present in 51% of cases. All but 4 were treated with corticosteroids. Another immunosuppressive agent or cerebral irradiation was added in 6 and 2 patients, respectively. Complete recovery was observed in 46%, improvement in 46%, 4% remained stable, and 4% worsened. There were no deaths. We advocate treating neurosarcoidosis with corticosteroids as early as possible. If the patient's condition worsens, additional immunosuppressive agents or cerebral irradiation is warranted.
Service de Médecine Interne, Hôpital de la Pitié, Paris, France.
C
C
Chapelon
J M
JM
Ziza
J C
JC
Piette
Y
Y
Levy
G
G
Raguin
B
B
Wechsler
M O
MO
Bitker
O
O
Blétry
D
D
Laplane
M G
MG
Bousser
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000628:therapy; D011859:Radiography; D012507:Sarcoidosis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000628:therapy