Diagnostic Criteria for Neurosarcoidosis

The Neurosarcoidosis Consortium Consensus Group met to discuss this sometimes challenging diagnosis. The pathologic hallmark of neurosarcoidosis is noncaseating granulomas in the nervous system. When the initial presentation is neurologic in nature, the authors emphasize the need to evaluate for extraneural sites and to consider biopsy for diagnostic confirmation before long-term immunosuppression is begun. Potential sites to scrutinize may include the eye, lymph nodes, lungs, and skin. Cerebrospinal fluid (CSF) can show nonspecific signs of active inflammation in most neurosarcoidosis patients, although not all. CSF testing may reveal a mononuclear pleocytosis, elevated protein, low glucose, and positive oligoclonal bands. Evaluations for …