What are the signs and symptoms of autonomic involvement in 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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Some patients with neurosarcoidosis may have small-fiber neuropathy with autonomic involvement. This may manifest as unexplained pain and dysesthesia, reduced warm and cold sensitivity, or even cardiac autonomic disturbances. Recognition of cardiac autonomic disturbances may be of clinical relevance because of their associated morbidity. [23]

Sudden death from systemic sarcoidosis is highly unusual. Rare cases of sudden death have been reported. The mechanism of action in one case was suspected to be involvement of the nucleus of the solitary tract in the brainstem, and the cause of death was attributed to central hypoventilation. [22] Another report describes a case of a woman aged 24 years who was found unconscious and subsequnetly died. No neurological symptoms were observed prior to this. Autopsy showed obstructive hydrocephalus. [24]

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