Overview
What is the pathophysiology of sarcoidosis in neurosarcoidosis?
What is the pathophysiology of neuropathy in neurosarcoidosis?
What is the prevalence of neurosarcoidosis in the US?
What is the global prevalence of neurosarcoidosis?
What are the racial predilections of neurosarcoidosis?
What are the sexual predilections of neurosarcoidosis?
Which age groups have the highest prevalence of neurosarcoidosis?
What is the prognosis of neurosarcoidosis?
Presentation
Which clinical history findings are characteristic of neurosarcoidosis?
How is neuropathy characterized in neurosarcoidosis?
What are presentations of cranial nerve mononeuropathy, in relation to neurosarcoidosis?
What are the signs and symptoms of cranial nerve mononeuropathies in neurosarcoidosis?
What are the signs and symptoms of peripheral neuropathies in neurosarcoidosis?
What are the signs and symptoms of CNS involvement in neurosarcoidosis?
How do seizures affect the prognosis of neurosarcoidosis?
What are the signs and symptoms of autonomic involvement in neurosarcoidosis?
What are signs of neurosarcoidosis?
Which physical findings are characteristic of neurosarcoidosis?
DDX
What should be excluded prior to a diagnosis of neurosarcoidosis in children?
When should a diagnosis of necrotizing neurosarcoidosis be considered?
What conditions are included in the differential diagnoses of neurosarcoidosis?
What are the differential diagnoses for Neurosarcoidosis?
Workup
How is neurosarcoidosis diagnosed?
How is peripheral neuropathy in neurosarcoidosis diagnosed?
Which CBC findings are characteristic of neurosarcoidosis?
What is the role of blood studies in the workup of neurosarcoidosis?
What is the role of liver function tests in the workup of neurosarcoidosis?
What is the role of endocrine studies in the workup of neurosarcoidosis?
What is the role of chest radiography in the workup of neurosarcoidosis?
What is the role of MRI in the workup of neurosarcoidosis?
Which findings on MRI are characteristic of neurosarcoidosis?
What is the role of FDG-PET in the workup of neurosarcoidosis?
What is the role of EMG and nerve conduction studies in the workup of neurosarcoidosis?
What is the role of evoked potential studies in the workup of neurosarcoidosis?
What is the role of CSF analysis in the workup of neurosarcoidosis?
What is the role of optical coherence tomography (OCT) in the workup of neurosarcoidosis?
What is the role of biopsy in the workup of neurosarcoidosis?
Which histologic findings are characteristic of neurosarcoidosis?
Treatment
How is neurosarcoidosis treated?
Which specialist consultations are beneficial to patients with neurosarcoidosis?
What is the role of immunosuppressants in the treatment of neurosarcoidosis?
What is the role of radiation in the treatment of neurosarcoidosis?
Medications
Which medications are used in the treatment of neurosarcoidosis?
Which medications in the drug class Immunomodulators are used in the treatment of Neurosarcoidosis?
Which medications in the drug class Antimalarials are used in the treatment of Neurosarcoidosis?
Which medications in the drug class Corticosteroids are used in the treatment of Neurosarcoidosis?
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Atrophic right optic disc of a 37-year-old man with neurosarcoidosis and involvement of both optic nerves. Vision was lost. The disc is pale with sharp borders.
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Atrophic left optic disc of a 37-year-old patient with neurosarcoidosis and involvement of both optic nerves. The disc is pale with sharp borders. Vision was largely preserved.
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MRI of the brain in a 37-year-old man with neurosarcoidosis who had complete loss of vision in the right eye for 2 months and occasional blurry vision in the left. T1-weighted sagittal image shows intact optic nerves.
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MRI of the brain in a 37-year-old man with neurosarcoidosis who had complete loss of vision in the right eye and mild left eye blurriness. This fluid-attenuated inversion recovery (FLAIR) axial image shows a wedge-shaped area of infarction in the right temporo-occipital area. The optic nerves exhibit abnormal signal.
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MRI of the brain in a 37-year-old patient with sarcoidosis who had right eye blindness and mild blurry vision in the left eye. This postgadolinium, T1-weighted axial image shows right optic nerve enhancement along almost the entire intraorbital portion and a small amount in the prechiasmatic portion. The left optic nerve enhances from the level of the optic chiasm to the distal intraorbital portion. The right temporo-occipital infarct is seen as a faint hypodensity; it does not enhance after gadolinium administration.
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MRI of the brain in a 37-year-old man with sarcoidosis who had loss of vision in the right eye and blurry vision in the left eye. This scan was taken 6 months after the scan shown in Pictures 3, 4, and 5. Both the right and left optic nerves are enlarged and show abnormal signal on this T1-weighted axial image. The patient remained on oral prednisone from the time of the first scan and did not exhibit any further loss of vision in the left eye. Vision in the right eye never returned.
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MRI of the brain in a 37-year-old man with sarcoidosis who had loss of vision in the right eye and blurry vision in the left. This postgadolinium, T1-weighted axial image shows abnormal enhancement of both optic nerves, with the left optic nerve appearing worse on this study than in the study shown as Picture 5, which was done 6 months earlier. The right temporo-occipital hypodensity represents the old infarction.
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Early chest radiograph findings in sarcoidosis.
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Advanced chest radiograph findings in sarcoidosis.
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Noncaseating granuloma surrounded by epithelioid cells, from the medulla oblongata. Also shown are nodular inflammatory infiltrates consisting of multinucleated giant cells, macrophages, and lymphocytes (hematoxylin and eosin, 40x).
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Noncaseating granuloma in medulla oblongata showing the granuloma surrounded by epithelioid cells and nodular inflammatory infiltrates (hematoxylin and eosin, 20x).