Brazilian perspectives on neurosarcoidosis broad spectrum

Abstract

Background

Neurosarcoidosis (NS) is a rare form of sarcoidosis, characterized by a wide range of neurological presentations due to granulomatous inflammation affecting different areas of the nervous system. The prevalence of NS in Brazil is not well-documented, suggesting a risk of underdiagnosis in this region.

Case Series

This study examines a series of five patients from Brazil with biopsy-confirmed systemic sarcoidosis and probable NS. Neurological manifestations varied widely, including longitudinally extensive myelitis, myopathy, cerebellar involvement, orbital apex syndrome, and multiple cranial neuropathies. NS was the initial presentation of sarcoidosis in most cases. Diagnoses were confirmed through a detailed assessment of clinical, radiological, laboratory, and pathological findings, following established NS diagnostic criteria. Each patient underwent MRI, cerebrospinal fluid analysis, and systemic evaluations, with systemic sarcoidosis confirmed by biopsy. Treatment primarily involved corticosteroids, with some patients requiring additional immunosuppressive therapy, resulting in favorable outcomes.

Conclusions

This case series highlights the diagnostic challenges of NS, particularly in Brazil, where awareness may be limited. Neurologists should consider NS in cases of unexplained neurological symptoms accompanied by systemic signs. Prompt diagnosis and treatment are essential to improve patient outcomes in this potentially debilitating condition.