Sarcoidosis of the nervous system
Although sarcoidosis is rarely confined to the nervous system, any neurological features that do occur frequently happen early in the course of the disease. The most common neurological presentation is with cranial neuropathies, but seizures, chronic meningitis and the effects of mass lesions are al...
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| Veröffentlicht in: | Practical neurology 2007-08, Vol.7 (4), p.234-244 |
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| creator | Joseph, F G Scolding, N J |
| description | Although sarcoidosis is rarely confined to the nervous system, any neurological features that do occur frequently happen early in the course of the disease. The most common neurological presentation is with cranial neuropathies, but seizures, chronic meningitis and the effects of mass lesions are also frequent. The diagnostic process should first confirm nervous system involvement and then provide supportive evidence for the underlying disease; in the absence of any positive tissue biopsy, the most useful diagnostic tests are gadolinium enhanced MRI of the brain and CSF analysis, although both are non-specific. The mainstay of treatment is corticosteroids, but these often have to be combined with other immunosuppressants such as methotrexate, hydroxychloroquine or cyclophosphamide. There is increasing evidence that infliximab is a safe treatment with good steroid sparing capacity. |
| doi_str_mv | 10.1136/jnnp.2007.124263 |
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The most common neurological presentation is with cranial neuropathies, but seizures, chronic meningitis and the effects of mass lesions are also frequent. The diagnostic process should first confirm nervous system involvement and then provide supportive evidence for the underlying disease; in the absence of any positive tissue biopsy, the most useful diagnostic tests are gadolinium enhanced MRI of the brain and CSF analysis, although both are non-specific. The mainstay of treatment is corticosteroids, but these often have to be combined with other immunosuppressants such as methotrexate, hydroxychloroquine or cyclophosphamide. There is increasing evidence that infliximab is a safe treatment with good steroid sparing capacity.</description><identifier>ISSN: 1474-7758</identifier><identifier>EISSN: 1474-7766</identifier><identifier>DOI: 10.1136/jnnp.2007.124263</identifier><identifier>PMID: 17636138</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd</publisher><subject>Autoimmune Diseases of the Nervous System - pathology ; Autoimmune Diseases of the Nervous System - physiopathology ; Autoimmune Diseases of the Nervous System - therapy ; Bacterial diseases ; Biological and medical sciences ; Borrelia infections ; Brain - immunology ; Brain - pathology ; Brain - physiopathology ; Cranial Nerve Diseases - immunology ; Cranial Nerve Diseases - physiopathology ; Granuloma - immunology ; Granuloma - pathology ; Granuloma - physiopathology ; Human bacterial diseases ; Human viral diseases ; Humans ; Immunosuppressive Agents - therapeutic use ; Infectious diseases ; Medical sciences ; Meningitis, Aseptic - complications ; Meningitis, Aseptic - immunology ; Meningitis, Aseptic - physiopathology ; Optic Nerve Diseases - immunology ; Optic Nerve Diseases - pathology ; Optic Nerve Diseases - physiopathology ; Sarcoidosis - pathology ; Sarcoidosis - physiopathology ; Sarcoidosis - therapy ; Skull Base - pathology ; Skull Base - physiopathology ; Tropical bacterial diseases ; Viral diseases ; Viral diseases of the lymphoid tissue and the blood. 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The most common neurological presentation is with cranial neuropathies, but seizures, chronic meningitis and the effects of mass lesions are also frequent. The diagnostic process should first confirm nervous system involvement and then provide supportive evidence for the underlying disease; in the absence of any positive tissue biopsy, the most useful diagnostic tests are gadolinium enhanced MRI of the brain and CSF analysis, although both are non-specific. The mainstay of treatment is corticosteroids, but these often have to be combined with other immunosuppressants such as methotrexate, hydroxychloroquine or cyclophosphamide. There is increasing evidence that infliximab is a safe treatment with good steroid sparing capacity.</description><subject>Autoimmune Diseases of the Nervous System - pathology</subject><subject>Autoimmune Diseases of the Nervous System - physiopathology</subject><subject>Autoimmune Diseases of the Nervous System - therapy</subject><subject>Bacterial diseases</subject><subject>Biological and medical sciences</subject><subject>Borrelia infections</subject><subject>Brain - immunology</subject><subject>Brain - pathology</subject><subject>Brain - physiopathology</subject><subject>Cranial Nerve Diseases - immunology</subject><subject>Cranial Nerve Diseases - physiopathology</subject><subject>Granuloma - immunology</subject><subject>Granuloma - pathology</subject><subject>Granuloma - physiopathology</subject><subject>Human bacterial diseases</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Immunosuppressive Agents - therapeutic use</subject><subject>Infectious diseases</subject><subject>Medical sciences</subject><subject>Meningitis, Aseptic - complications</subject><subject>Meningitis, Aseptic - immunology</subject><subject>Meningitis, Aseptic - physiopathology</subject><subject>Optic Nerve Diseases - immunology</subject><subject>Optic Nerve Diseases - pathology</subject><subject>Optic Nerve Diseases - physiopathology</subject><subject>Sarcoidosis - pathology</subject><subject>Sarcoidosis - physiopathology</subject><subject>Sarcoidosis - therapy</subject><subject>Skull Base - pathology</subject><subject>Skull Base - physiopathology</subject><subject>Tropical bacterial diseases</subject><subject>Viral diseases</subject><subject>Viral diseases of the lymphoid tissue and the blood. 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Aids</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Joseph, F G</creatorcontrib><creatorcontrib>Scolding, N J</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Practical neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Joseph, F G</au><au>Scolding, N J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Sarcoidosis of the nervous system</atitle><jtitle>Practical neurology</jtitle><addtitle>Pract Neurol</addtitle><date>2007-08</date><risdate>2007</risdate><volume>7</volume><issue>4</issue><spage>234</spage><epage>244</epage><pages>234-244</pages><issn>1474-7758</issn><eissn>1474-7766</eissn><abstract>Although sarcoidosis is rarely confined to the nervous system, any neurological features that do occur frequently happen early in the course of the disease. The most common neurological presentation is with cranial neuropathies, but seizures, chronic meningitis and the effects of mass lesions are also frequent. The diagnostic process should first confirm nervous system involvement and then provide supportive evidence for the underlying disease; in the absence of any positive tissue biopsy, the most useful diagnostic tests are gadolinium enhanced MRI of the brain and CSF analysis, although both are non-specific. The mainstay of treatment is corticosteroids, but these often have to be combined with other immunosuppressants such as methotrexate, hydroxychloroquine or cyclophosphamide. There is increasing evidence that infliximab is a safe treatment with good steroid sparing capacity.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd</pub><pmid>17636138</pmid><doi>10.1136/jnnp.2007.124263</doi><tpages>11</tpages></addata></record> |
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| subjects | Autoimmune Diseases of the Nervous System - pathology Autoimmune Diseases of the Nervous System - physiopathology Autoimmune Diseases of the Nervous System - therapy Bacterial diseases Biological and medical sciences Borrelia infections Brain - immunology Brain - pathology Brain - physiopathology Cranial Nerve Diseases - immunology Cranial Nerve Diseases - physiopathology Granuloma - immunology Granuloma - pathology Granuloma - physiopathology Human bacterial diseases Human viral diseases Humans Immunosuppressive Agents - therapeutic use Infectious diseases Medical sciences Meningitis, Aseptic - complications Meningitis, Aseptic - immunology Meningitis, Aseptic - physiopathology Optic Nerve Diseases - immunology Optic Nerve Diseases - pathology Optic Nerve Diseases - physiopathology Sarcoidosis - pathology Sarcoidosis - physiopathology Sarcoidosis - therapy Skull Base - pathology Skull Base - physiopathology Tropical bacterial diseases Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids |
| title | Sarcoidosis of the nervous system |
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