Differentiating LETM Due to Neurosarcoidosis vs. Neuromyelitis Optica

Diagnosing neurosarcoidosis (NS) can be a challenge, particularly when no accessible lymph node is available for biopsy. Both NS and neuromyelitis optica spectrum disorders (NMOSD) can present with longitudinally extensive transverse myelitis (LETM), making differential diagnosis challenging. In this retrospective study, researchers evaluated 71 patients seen at one center with sarcoidosis or NMOSD who presented with LETM.

NMOSD patients were significantly more likely than NS patients to be female and to have concurrent or preceding optic neuritis, prior or concurrent episodes of intractable nausea and vomiting, paroxysmal tonic spasms, coexisting serologic or systemic evidence of autoimmunity, and ring enhancement on imaging. NS patients we…