Neurologic Manifestations in Sarcoidosis

Abstract

Nervous system involvement by sarcoidosis is considered rare, yet more than 400 cases were reported. Additional cases (23) were presented, including 14 with autopsies, and the literature was reviewed. The overall frequency of neurologic involvement was 5%. Patients usually had other stigmata of sarcoidosis; neurologic dysfunction was frequently the presenting finding. The protean manifestations of CNS involvement usually occurred in the early phase of the disease; those of peripheral nervous system and skeletal muscle involvement were characteristically seen in the chronic stages. Basal granulomatous meningitis caused most of the CNS manifestations either by infiltration or compression of adjacent structures. Steroids were the mainstay of therapy, and the overall response was quite variable. The course was also variable, being transient in some and chronic in others. The prognosis was better with peripheral than with CNS involvement.