[Neurosarcoidosis]

A neurological localization is observed in 20% of the cases of sarcoidosis. Involvement of the central and/or peripheral nervous system is generally observed in Caucasians while cranial nerve localization predominates in blacks. Beside these particular elements, lymphocytic meningitis, psychiatric disorders, insipid diabetes, and cranial nerve palsy are the most frequent signs. A cerebrospinal fluid test as well as brain and spinal cord MRI with gadolinium injection is required in all cases. Depending on the clinical expression, complementary tests may include PEA, PEV and neuropsychic tests. Histological proof of sarcoidosis granuloma is required for diagnosis but may be difficult to obtain when neurological signs are not associated with another localization. Systemic treatment is indicated, based on steroids, sometimes associated with another immunosuppressive agent. After acute treatment, chronic therapy must be maintained for years, and sometimes for life.