Which clinical history findings are characteristic 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

Onset of neurosarcoidosis is most often in the fourth or fifth decade of life, but the disease affects children and the elderly as well. Neuropathy is rarely the presenting feature of sarcoidosis; commonly it reflects a neurologic extension of existing sarcoidosis, usually occurring within 2 years of onset of systemic illness (eg, fatigue, malaise, arthralgia, fever, and weight loss).

In patients known to have sarcoid, the appearance of neurologic symptoms usually poses no diagnostic problems. However, the possibility of unrelated disease, especially infections, must be kept in mind. The symptoms can be acute, subacute, or chronic.

  • Clinical presentations are diverse and include the following:

  • Diffuse sensorimotor neuropathy

  • Distal-to-proximal slowly progressive weakness

  • Distal numbness and dysesthesia

  • Multifocal neuropathies that mimic mononeuritis multiplex

  • Mononeuropathy

  • An acute generalized demyelinating motor neuropathy similar to Guillain-Barré syndrome

  • Generalized or localized muscle weakness or soreness


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