title: Dramatic MRI improvement with refractory neurosarcoidosis treated with infliximab.
abstract: BACKGROUND
  Neurosarcoidosis is often a devastating, refractory condition without definite pharmacotherapies beyond corticosteroids.
  
  
  OBJECTIVE
  To describe a case of steroid-refractory neurosarcoidosis with a marked clinical and radiological response to infliximab.
  
  
  METHODS
  We describe the case of a young female patient with biopsy-proven neurosarcoidosis leading to gait failure. She described significant corticosteroid-related side effects without clinical response to the therapy. Infliximab therapy was considered as a possible rescue medication.
  
  
  RESULTS
  Within months of starting intravenous infliximab therapy, she regained her ability to walk and magnetic resonance imaging identified significant improvements over a sustained course of infliximab therapy, including loss of enhancing nodules and loss of meningeal enhancement.
  
  
  CONCLUSIONS
  Mounting evidence suggests that infliximab is a valuable pharmacological agent in the management of patients with refractory and disabling neurosarcoidosis. Controlled studies of infliximab in this condition are needed.
authors.affiliation: Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada. corytoth@shaw.ca
authors.forename: C
authors.initials: C
authors.lastname: Toth
authors.forename: L
authors.initials: L
authors.lastname: Martin
authors.forename: W
authors.initials: W
authors.lastname: Morrish
authors.forename: S
authors.initials: S
authors.lastname: Coutts
authors.forename: I
authors.initials: I
authors.lastname: Parney
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D002493:Central Nervous System Diseases / Q000188:drug therapy* / Q000473:pathology*; D005260:Female; D006801:Humans; D000069285:Infliximab; D008279:Magnetic Resonance Imaging; D012507:Sarcoidosis / Q000188:drug therapy* / Q000473:pathology*; D016896:Treatment Outcome