What is Neurosarcoidosis?
This is not a disease but is a complication or neurological manifestations of a more serious disease called Sarcoidosis. This manifestation of your neurological system normally happens to young adults between the ages of twenty and forty. Neurosarcoidosis develops in five to fifteen percent of individuals who have been diagnosed with Sarcoidosis. It can start out as a slow chronic disease or in an acute, explosive disease. It can be cause permanent disability. It may go away in four to six months; it could continue periodically for the rest of your life or be a life-threatening disease.
The symptoms can be mild and progress slowly or they could be severe and come on suddenly. The degree of nerve involvement determines what type of symptoms that a person may have. The symptoms can include:
- Muscle wasting or weakness
- Loss of smell
- Excessive thirst
- Numbness in different parts of your body
- Agitation and/or irritability
- Memory loss
- Hearing, vision, or voice impairments
- Loss of taste or abnormal tastes
- Mood or behavior changes
The most common symptom of Neurosarcoidosis is having sudden facial weakness also referred to as facial palsy. Bells Palsy is considered one of the symptoms. This involves the nerves of the muscles of your face but any nerve in your skull may be affected, which is why you can have a variety of symptoms. Because it can also affect other parts of your brain that regulates many other functions of your body you could also have symptoms that affect the temperature of your body and stress and sleep functions. Not everyone has the same symptoms.
Sarcoidosis is a chronic disease that can affect many different parts of your body but mostly your lungs. Basically the cause of this complication is not known. Some physicians think that it happens when there is an overreaction of your immune system with a foreign substance or because a person has inherited a certain mixture of genes. What they do know is that Neurosarcoidosis causes inflammation in your spinal cord, brain, and in other areas of your nervous system. You can also have abnormal deposits or tiny lumps of cells in part of your nervous system that can affect their functioning correctly.
It is often difficult to diagnosis Neurosarcoidosis but by doing a biopsy physicians can get a definitive diagnosis. The reason to a biopsy to diagnosis Neurosarcoidosis is to see if there are groups of inflammatory cells, or granulomas. Physicians will usually avoid doing brain biopsies because of the many risks that are associated with doing this type of biopsy. Physicians may also use:
- Computed pomography (CT scan)
- Lumbar puncture—this test can tell if there is any sign of inflammation but this is not a test that is very reliable.
- Magnetic resonance imaging (MRI)—this is the most useful test when they use gadolinium enhancement.
- Electroencephalography (EEG)
- Scans that use radioactive elements.
The physician may also order blood tests although they may not be very helpful in the diagnosis. They will also do a physical exam and take a detailed medical history.
The treatment that the physician chooses to use will depend on what symptoms the patient is exhibiting and how severe the symptoms are. Treatment can take a long time because nerve tissue does not heal quickly. There may also be high doses of several medications that you may need to take for a long period of time. The primary or first line of treatment is using prednisone, which is an anti-inflammatory medication also known as a corticosteroid. You would need to take this medication for many months and sometimes it may even be a year or longer. Unfortunately if prednisone is used at a high dose for a long period of time it can cause some very serious side effects such as:
- High blood pressure
- It can also affect your body’s production of certain hormones.
If you cannot handle the side effects or your condition gets worse while on prednisone the physician may prescribe other medications but they can also cause serious side effects. These other medications that can be prescribed are called immunosuppressants.
One thing to note is there is no cure for this complication of Sarcoidosis or for the disease itself. The treatment that the physician uses is just to help reduce the symptoms. If you have weakness, hearing or vision problems, or numbness you may need to have physical therapy or have to use a walker or cane.
Pictures of Neurosarcoidosis…