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.
Address correspondence to Dr Jinny Tavee, Cleveland Clinic Foundation, Neuromuscular Center, 9500 Euclid Avenue, Cleveland, OH 44195, firstname.lastname@example.org.
Relationship Disclosure: Dr Tavee is involved in a clinical trial funded by Araim Pharmaceuticals, Inc, evaluating the use of ARA290 in patients with small fiber neuropathy related to sarcoidosis. Dr Stern has served as an expert witness, as editor of The Neurologist, and serves on the Data and Safety Monitoring Board and as a medical safety monitor at the National Institute of Neurological Disorders and Stroke. Dr Stern receives research support from the National Institute of Neurological Disorders and Stroke and Remedy Pharmaceuticals.
Unlabeled Use of Products/Investigational Use Disclosure: Drs Tavee and Stern report no disclosures.