Clinical and Laboratory Characteristics of Patients with Neurosarcoidosis

Neurosarcoidosis (NS) represents the most severe complication of sarcoidosis. NS exhibits a diverse array of clinical and radiological features that mimic many inflammatory, infectious, and neoplastic neurological disorders. In our study, we evaluated the demographic, clinical, laboratory, and imaging features of patients with NS.

In this retrospective observational study, we included patients with definite and probable NS with at least 6-months of follow-up. Diagnostic tests, including cerebrospinal fluid analysis and imaging findings, lesion localization, therapeutic interventions, and disease course were evaluated. The modified Rankin scale was employed as a metric to assess the severity of the disease.

Fourteen patients met the inclusion criteria; two were definitively diagnosed with NS through brain biopsy, while twelve received a probable NS diagnosis based on biopsies of non-neuronal tissues. The predominant initial manifestation of NS was cranial neuropathy (64.3%), with facial palsy emerging as the most prevalent subset (35.7%). Five patients exhibited parenchymal involvement, while leptomeningeal involvement was noted in two. All patients were treated with corticosteroids, with nine individuals (64.3%) necessitating additional immunosuppressive interventions. Stable disease or improvement was observed in the majority of patients (85.7%), albeit one case resulted in mortality.

We observed favorable outcomes in the majority of patients. Nevertheless, it's imperative to acknowledge that NS can lead to both mortality and severe morbidity. Recognizing clinical patterns is vital for accurate diagnosis and effective treatment. However, there is an existing gap in management, underscoring the necessity for randomized controlled trials aimed at elucidating optimal treatment strategies.