Neurosarcoidosis: diagnosis, therapy and biomarkers

Abstract

Sarcoidosis is a multi-organ immune-mediated disease, which manifests as neurosarcoidosis (NS) in approximately 10% of all affected patients. The diagnosis of NS requires a high degree of suspicion as well as histological confirmation. Neurological symptoms in patients with systemic sarcoidosis should not be assumed to be due to NS unless proven true. The etiopathogenesis of NS is not yet fully elucidated and a reliable biomarker assessing disease progression is missing. As a probable result, there is no definitive cure for NS. The goals of available treatments include: halting inflammation, prevention of disease worsening and restoring neurological functions whenever possible. With immunosuppression, clinical remission of NS occurs in the majority of patients. However, in some others, the disease may still progress, as no permanent cure is yet available.

Keywords: biomarkers cerebrospinal fluid; granuloma; leptomeningeal enhancement; magnetic resonance imaging; monocolonal antibodies; myelitis; neuropathy; neurosarcoidosis.