New cerebrospinal fluid, neurophysiological and neuroradiological examinations in the diagnosis and follow-up of neurosarcoidosis.

For a complete evaluation of a patient with suspected neurosarcoidosis, combination of the newer CSF, neurophysiological, and neuroradiological studies is needed. CSF enzyme studies are useful in cerebral lesions and especially in cranial nerve lesions where CT and MRI usually fail to show abnormalities. Evoked potential examinations are a helpful noninvasive method for detection of both cerebral and cranial nerve lesions. Although CT and MRI are mainly abnormal in patients with cerebral symptoms they can disclose unexpected CNS involvement even in patients with mainly cranial nerve affection. However, even the newest diagnostic methods are nonspecific, and histologically verified systemic sarcoidosis still remains the mainstay of diagnosis.