Neurosarcoidosis: a review from diagnosis and future perspectives

Sarcoidosis is complicated by neurosarcoidosis in 5–15% of cases. Neurosarcoidosis is characterized by the presence of non-necrotizing granulomas that can affect any part of the nervous system. Key clinical presentations include chronic meningitis, cranial nerve palsies, parenchymal cerebral and spi...

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Bibliographic Details
Published in:EClinicalMedicine Vol. 90; p. 103653
Main Authors: Westendorp, Willeke F., van de Beek, Diederik, Brouwer, Matthijs C.
Format: Journal Article
Language:English
Published: Elsevier Ltd 01.12.2025
Elsevier
Subjects:
Cranial nerve palsy
Immunosuppressive treatment
Internal Medicine
Meningitis
Myelitis
Sarcoidosis
TNF-α antagonists
Myelitis
Meningitis
TNF-α antagonists
Sarcoidosis
Cranial nerve palsy
Immunosuppressive treatment
ISSN:2589-5370, 2589-5370
Online Access:Get full text
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Summary:Sarcoidosis is complicated by neurosarcoidosis in 5–15% of cases. Neurosarcoidosis is characterized by the presence of non-necrotizing granulomas that can affect any part of the nervous system. Key clinical presentations include chronic meningitis, cranial nerve palsies, parenchymal cerebral and spinal lesions, peripheral neuropathy, or myopathy. Diagnosis requires histopathological confirmation of granulomatous disease and exclusion of other potential diagnoses. Immunosuppressive treatment strategies are based on cohort studies and expert consensus, as randomized controlled trials are lacking. Neurosarcoidosis is associated with high morbidity, with only one third of patients being symptom-free status after treatment. Optimal care should be centralized to provide specialized multidisciplinary expertise and facilitate research. Future research should focus on the optimal timing of 3rd line treatment initiation and treatment personalization. The Netherlands Organisation for Health Research and Development (ZonMw), European Research Council.
ISSN:2589-5370
2589-5370
DOI:10.1016/j.eclinm.2025.103653