Neurosarcoidosis: a clinical dilemma.
Sarcoidosis is an inflammatory multisystem disorder of unknown cause. Practically no organ is immune to sarcoidosis; most commonly, in up to 90% of patients, it affects the lungs. The nervous system is involved in 5-15% of patients. Neurosarcoidosis is a serious and commonly devastating complication of sarcoidosis. Clinical diagnosis of neurosarcoidosis depends on the finding of neurological disease in multisystem sarcoidosis. As the disease can present in many different ways without biopsy evidence, solitary nervous-system sarcoidosis is difficult to diagnose. Corticosteroids are the drug of first choice. In addition, several cytotoxic drugs, including methotrexate, have been used to treat sarcoidosis. The value of new drugs such as anti-tumour necrosis factor alpha will be assessed. In this review we describe the clinical manifestations of neurosarcoidosis, diagnostic dilemmas and considerations, and therapy.
Hoitsma
Elske
E
Department of Neurology, Sarcoidosis Management Center, University Hospital Maastricht, Netherlands. elske.hoitsma@wanadoo.nl
Faber
Carin G
CG
Drent
Marjolein
M
Sharma
Om P
OP
D000276:Adjuvants, Immunologic / Q000627:therapeutic use; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology; D012507:Sarcoidosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology
D000276:Adjuvants, Immunologic; D000305:Adrenal Cortex Hormones