What is the prognosis of neurosarcoidosis?

Updated: Nov 13, 2018
  • Author: Gabriel Bucurescu, MD, MS; Chief Editor: Tarakad S Ramachandran, MBBS, MBA, MPH, FAAN, FACP, FAHA, FRCP, FRCPC, FRS, LRCP, MRCP, MRCS  more...
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Answer

Spontaneous resolution of neurosarcoidosis after 4-6 months may occur but is uncommon. Many patients have a slowly progressive chronic course with intermittent exacerbations. About 5% of patients with sarcoidosis die of this disorder. Brainstem involvement can be life-threatening. Two cases of sudden death have been attributed to cardiac sarcoidosis and hypothalamic infiltration. [8]

Although the neuropathy generally responds to steroid therapy, the long-term outcome of neurosarcoidosis has not been clearly defined. Nevertheless, the following generalizations are possible on the basis of observations of treated individuals:

  • Peripheral facial nerve palsy tends to improve over 2-4 weeks

  • Optic neuropathy can improve over several weeks, but some patients have a progressive course ending in blindness

  • Peripheral neuropathic and myopathic illness tends to be chronic and progressive, although remissions are possible

Most patients with peripheral neuropathy from sarcoidosis also exhibit other systemic or CNS manifestations of the disease. These manifestations pose greater morbidity and mortality risks than polyneuropathy alone.


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