Department of Neurology, Diaconessenhuis Leiden, Leiden, The Netherlands.
Curr Opin Pulm Med. 2010 Sep;16(5):472-9. doi: 10.1097/MCP.0b013e32833c86df.
Neurosarcoidosis may be a serious complication of sarcoidosis. As the presentation of neurosarcoidosis is manifold, solitary nervous system sarcoidosis without systemic activity remains a difficult diagnosis. Appropriate treatment may be a dilemma.
Most neurosarcoidosis patients present with neurological symptoms as the first manifestation. Whole-body fluorodeoxyglucose positron emission tomography has been found useful in neurological patients suspected of sarcoidosis. Small-fiber neuropathy is commonly associated with sarcoidosis and can cause significant morbidity to afflicted patients. New drugs such as antitumor necrosis factor alpha have been proven valuable in the treatment of neurosarcoidosis in different locations. Progressive multifocal leucencephalopathy should be considered in neurosarcoid patients, especially when treatment fails.
In this paper an update on clinical manifestations of neurosarcoidosis, diagnostic dilemmas, and therapeutic options is provided.
神经结节病可能是结节病的严重并发症。由于神经结节病的表现多种多样，没有全身活动的孤立性神经系统结节病仍然是一个难以诊断的问题。适当的治疗可能是一个困境。
大多数神经结节病患者以神经系统症状为首发表现。全身氟脱氧葡萄糖正电子发射断层扫描已被发现对疑似结节病的神经科患者有用。小纤维神经病常与结节病有关，并可导致受影响患者出现显著的发病率。新型药物如抗肿瘤坏死因子α已被证明对不同部位的神经结节病的治疗有价值。在神经结节病患者中应考虑进行进行性多灶性白质脑病，尤其是在治疗失败时。
本文就神经结节病的临床表现、诊断难题和治疗选择提供了最新进展。
