Purpose of Review:
This article provides an update on the evaluation and treatment of neurosarcoidosis.
The broad range of clinical manifestations of neurosarcoidosis has recently expanded to include painful small fiber neuropathy. Although definitive diagnosis remains a challenge, fluorodeoxyglucose positron emission tomographic (FDG-PET) scan and high-resolution CT allow for improved detection of systemic sarcoidosis. In addition, endobronchial ultrasound-guided transbronchial needle aspiration provides a less invasive means of tissue confirmation of systemic sarcoidosis than mediastinoscopy. Although not standardized, treatment strategies for neurosarcoidosis now commonly include tumor necrosis factor-α antagonists in combination with corticosteroids and other cytotoxic agents for patients with severe disease.
Advances in the diagnosis and management of neurosarcoidosis may benefit the patient and clinician faced with this multifaceted disease.