Clinical features and diagnosis of neurosarcoidosis – review article

Barreras, Paula; Stern, Barney J.

doi:10.1016/j.jneuroim.2022.577871

Cited by 20 publications

(17 citation statements)

References 61 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Prior to this, he did notice systemic symptoms, but his severe headache, nausea, and seizure on arrival are what prompted a further workup. CNS manifestations are more common (80%) than peripheral nervous system (PNS) manifestations [ 6 ], with it most commonly presenting as cranial neuropathies (50%-75%) [ 1 , 4 , 6 , 7 ]. Our patient presented with signs and symptoms of CNS inflammation, likely indicated by the leptomeningeal enhancement seen on MRI.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Resolution of Possible Neurosarcoidosis With Early Initiation of Glucocorticoids in the Acute Inpatient Setting: A Case Report

Modica,

Sacklow,

McCullough

2023

Cureus

View full text Add to dashboard Cite

Neurosarcoidosis is an autoimmune disorder of unknown etiology. We report a case of a 27-year-old African American male presenting with fever, vomiting, and seizure. Initially, bacterial meningitis was suspected, and empiric antibiotics with dexamethasone were started. Workup revealed negative cultures, leptomeningeal enhancement, and cavitary lung nodules with hilar lymphadenopathy on imaging and elevated angiotensin-converting enzyme levels on cerebrospinal fluid (CSF) analysis. Neurosarcoidosis was then suspected, and a lung biopsy was performed. The results were inconclusive, but the patient’s condition improved. He was discharged on prednisone. Our case demonstrates the diagnostic difficulty of neurosarcoidosis while displaying the importance of early initiation of glucocorticoids in the acute inpatient setting.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Our patient presented with signs and symptoms of CNS inflammation, likely indicated by the leptomeningeal enhancement seen on MRI. Aseptic meningitis accounts for 10%-20% [ 1 , 4 , 6 , 7 ] of neurological manifestations, with leptomeningeal involvement seen in approximately 40% of patients on MRI [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Resolution of Possible Neurosarcoidosis With Early Initiation of Glucocorticoids in the Acute Inpatient Setting: A Case Report

Modica,

Sacklow,

McCullough

2023

Cureus

View full text Add to dashboard Cite

show abstract

“…In early disease, spinal cord involvement presents as nodular leptomeningeal enhancement along the spinal cord. Late manifestations of cord involvement include elongated eccentric intramedullary T1 hypointensity and T2 hyperintensity with patchy post-contrast enhancement, typically in the cervicothoracic spine, with subsequent cord atrophy [ 13 , 14 , 21 ].…”

Section: Autoimmune/inflammatory Disorders and Vasculitidesmentioning

confidence: 99%

Imaging More than Skin-Deep: Radiologic and Dermatologic Presentations of Systemic Disorders

et al. 2022

View full text Add to dashboard Cite

Background: Cutaneous manifestations of systemic diseases are diverse and sometimes precede more serious diseases and symptomatology. Similarly, radiologic imaging plays a key role in early diagnosis and determination of the extent of systemic involvement. Simultaneous awareness of skin and imaging manifestations can help the radiologist to narrow down differential diagnosis even if imaging findings are nonspecific. Aims: To improve diagnostic accuracy and patient care, it is important that clinicians and radiologists be familiar with both cutaneous and radiologic features of various systemic disorders. This article reviews cutaneous manifestations and imaging findings of commonly encountered systemic diseases. Conclusions: Familiarity with the most disease-specific skin lesions help the radiologist pinpoint a specific diagnosis and consequently, in preventing unnecessary invasive workups and contributing to improved patient care.

show abstract

“…Sarcoidosis, especially isolated organ involvement types such as neurosarcoidosis (NS), is far less likely to be high on the list of differential diagnoses for patients in the non-endemic areas of the US, such as our Southwestern US region, than for those in the areas of high prevalence. While sarcoidosis most commonly involves the lungs, skin, and eyes ( 4 ), sarcoid can affect any organ system in the body ( 5 , 6 ), and is highly diverse when involving the nervous system ( 7–9 ). NS is identified in 5–10% of patients, in half of which it may be the initial clinical presentation ( 10 ).…”

Section: Introductionmentioning

confidence: 99%

Diagnostic challenges of neurosarcoidosis in non-endemic areas

Shrestha,

Kleinschmidt-DeMasters,

Ormond

2024

Front. Neurol.

View full text Add to dashboard Cite

BackgroundNeurosarcoidosis (NS) is a challenging diagnosis, particularly when cases occur in low-prevalence, non-endemic geographic regions. In the United States, the highest incidence is in the Midwest and Northeast, compared to our Southwest location. While it is well known that NS may clinically and neuroradiographically mimic meningeal carcinomatosis, autoimmune or infectious pachymeningitis, neurosyphilis, or tuberculosis, diagnosis may be particularly challenging if systemic signs of sarcoidosis are lacking or unconfirmed or if dural-based masses are present. We reviewed our Colorado experience with NS cases, focusing our study on cases where NS represented the first histological confirmation of disease.MethodsA search of departmental databases was conducted with the search term “neurosarcoidosis” to identify cases 1-2008 to 12-2019, inclusive of the given case numbers. Patients were only included if their clinical and neuroimaging features were unusual and only when a biopsy of the central nervous system (CNS) represented the first confirmed diagnosis of sarcoidosis.ResultsA total of 17 cases were identified, of which the biopsy of the CNS was used for the initial confirmation of the disease in 9 of them. The most unusual findings were two patients with dural-based masses, one of which had pure NS as the cause of meningioma-like lesions and the second of which had coexistent meningioma and intimately admixed non-necrotizing granulomas of NS.ConclusionNS with unusual features, especially in non-endemic areas, continues to yield diagnostic challenges for neurologists, neuroradiologists, and pathologists.

show abstract

Clinical features and diagnosis of neurosarcoidosis – review article

Cited by 20 publications

References 61 publications

Resolution of Possible Neurosarcoidosis With Early Initiation of Glucocorticoids in the Acute Inpatient Setting: A Case Report

Resolution of Possible Neurosarcoidosis With Early Initiation of Glucocorticoids in the Acute Inpatient Setting: A Case Report

Imaging More than Skin-Deep: Radiologic and Dermatologic Presentations of Systemic Disorders

Diagnostic challenges of neurosarcoidosis in non-endemic areas

Contact Info

Product

Resources

About