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Joint Bone Spine 2021 May 31:105232. Epub 2021 May 31.

MD, Hôpital Pitié Salpêtrière - Assistance Publique Hôpitaux de Paris, Rheumatology department, Pain unit ; 47-83 boulevard de l'hôpital, 75013 Paris, France. Electronic address:

Fibromyalgia and small fibre neuropathy are two diseases leading to chronic widespread pain, and it is difficult to differentiate them in order to provide appropriate care. In this review, we will describe the pathophysiological and clinical differences between fibromyalgia and small fibre neuropathy. In fibromyalgia, pain is increased by dysregulation of central pain processing while small fibre neuropathy pain is related to loss or dysfunction of intraepidermal small nerve fibres. Read More

BMJ Case Rep 2021 May 24;14(5). Epub 2021 May 24.

Department of Ophthalmology and Visual Sciences, Yale School of Medicine, New Haven, Connecticut, USA

A 48-year-old woman with untreated hypothyroidism initially presented with tinnitus and hearing loss, followed by blurred vision and eye pain months later. Ophthalmic evaluation revealed no optic disc oedema. Visual field defects in both eyes suggested retrobulbar optic neuropathy. Read More

J Neurol 2021 Apr 21. Epub 2021 Apr 21.

Department of Molecular Neurology and Therapeutics, Kumamoto University Hospital, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.

Objective: To determine whether autonomic dysfunction in neurosarcoidosis is associated with anti-ganglionic acetylcholine receptor (gAChR) antibodies, which are detected in autoimmune autonomic ganglionopathy.

Methods: We retrospectively extracted cases of sarcoidosis from 1787 serum samples of 1,381 patients between 2012 and 2018. Anti-gAChR antibodies against the α3 and β4 subunit were measured by luciferase immunoprecipitation to confirm the clinical features of each case. Read More

Clin Geriatr Med 2021 May 23;37(2):327-345. Epub 2021 Mar 23.

Department of Neurology, Virginia Commonwealth University, 1101 East Marshall Street, PO Box 980599, Richmond, VA 23298, USA. Electronic address:

This article discusses the chronic immune-mediated polyneuropathies, a broad category of acquired polyneuropathies that encompasses chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), the most common immune-mediated neuropathy, the CIDP variants, and the vasculitic neuropathies. Polyneuropathies associated with rheumatological diseases and systemic inflammatory diseases, such as sarcoidosis, will also be briefly covered. These patients' history, examination, serum studies, and electrodiagnostic studies, as well as histopathological findings in the case of vasculitis, confirm the diagnosis and differentiate them from the more common length-dependent polyneuropathies. Read More

J Neurol Sci 2021 05 27;424:117421. Epub 2021 Mar 27.

University of Virginia, Department of Neurology, Charlottesville, VA, USA.

Rheumatological diseases result in immune-mediated injury to not only connective tissue, but often components of the peripheral nervous system. These overlap conditions can be broadly categorized as peripheral neuropathies and overlap myositis. The peripheral neuropathies are distinctive as many have unusual presentations such as non-length-dependent, small fiber neuropathies and sensory neuronopathies (both due to dorsal root ganglia dysfunction), multiple mononeuropathies (e. Read More

Audiol Neurootol 2021 Apr 6:1-7. Epub 2021 Apr 6.

Assistance Publique Hôpitaux de Paris, GH Pitié-Salpêtrière, Service ORL, Unité Fonctionnelle Implants Auditifs, Sorbonne Université, Paris, France.

Introduction: Audiovestibular symptoms are rare in sarcoidosis, but they may also be the first manifestation of the disease. Sudden or progressive bilateral hearing loss is usually associated with vestibular impairment. The mechanism of hearing loss remains unclear, but clinical presentation and magnetic resonance imaging suggest a retrocochlear site for the lesion in most patients. Read More

Taiwan J Ophthalmol 2021 Jan-Mar;11(1):104-107. Epub 2021 Jan 25.

Department of Ophthalmology, Emory Eye Center, Emory University School of Medicine, Atlanta, GA, USA.

Neurosarcoidosis is a rare complication of sarcoidosis and typically presents as acute cranial neuropathies. Neurosarcoidosis can rarely cause an inflammatory optic neuropathy, resembles an optic neuritis and even more rarely can cause an optic perineuritis. Although concomitant optic neuritis and optic perineuritis have been reported in other inflammatory conditions, such as myelin oligodendrocyte antibody-associated disease, spatially-distinct optic neuritis, and optic perineuritis has not been previously described in neurosarcoidosis. Read More

Tidsskr Nor Laegeforen 2021 03 22;141(5). Epub 2021 Mar 22.

Background: Neurosarcoidosis is a rare form of sarcoidosis that affects the nervous system. The aim of the study was to survey clinical manifestations, findings from assessments and treatment strategies for patients with neurosarcoidosis.

Material And Method: The study performed a retrospective assessment of 17 patients with definitive, probable and possible neurosarcoidosis diagnosed in the period 2008-2019 at the Department of Neurology, Haukeland University Hospital. Read More

Front Neurol 2020 29;11:627077. Epub 2021 Jan 29.

Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

Optic perineuritis (OPN) is a special optic neuropathy that has a distinct etiology from neuromyelitis optica spectrum disorders (NMOSDs) or multiple sclerosis (MS)-related optic neuritis (ON). The mechanisms of how this inflammation developed and invaded the nerve sheath remain unknown. This study is aimed to analyze the etiology and different clinical characteristics of OPN in a Chinese patient population. Read More

J Neurol Sci 2021 01 19;420:117282. Epub 2020 Dec 19.

Mayo Clinic, Department of Neurology, 200 1st St. SW, Rochester, MN, USA. Electronic address:

Objective: The diagnosis of sarcoid optic neuropathy is time-sensitive, as delayed treatment risks irreversible vision loss. We sought to analyze its characteristics and outcomes.

Methods: We performed a multi-center retrospective study of sarcoid optic neuropathy among 5 USA medical centers. Read More

Intern Med 2021 May 30;60(9):1469-1473. Epub 2020 Nov 30.

Department of Neurology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Japan.

We herein report a 73-year-old woman case with sarcoid neuropathy showing nerve enlargement assessed by nerve ultrasound both before and after treatment. The site of conduction block in the left tibial nerve corresponded to the site of nerve enlargement with a hypo-echoic pattern. After treatment with prednisolone, nerve ultrasound detected the remission of the nerve enlargement, and the conduction block and clinical symptoms also improved. Read More

Ann Indian Acad Neurol 2020 Jul-Aug;23(4):528-535. Epub 2020 Jun 29.

Neurology Unit, Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India.

Context: Neurosarcoidosis (NS) is a chronic disease with a diverse clinical spectrum, therapeutic response, and outcome. There is scarce literature from our country regarding the same.

Aims: The aim of this study was to evaluate the clinical spectrum, therapeutic responses, and outcomes of NS in an Indian cohort. Read More

Ocul Immunol Inflamm 2020 Nov 9:1-8. Epub 2020 Nov 9.

Département de Médecine Interne et Immunologie Clinique, Sorbonne Université, Centre National De Référence Maladies Autoimmunes Systémiques Rares, Centre National De Référence Maladies Autoinflammatoires et Amylose Inflammatoire. INSERM UMRS 959, Immunologie-Immunopathologie-Immunotherapie, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France.

: Neuro-ophthalmologic manifestations are uncommon in sarcoidosis. We aim to assess the prognostic factors and outcome of neuro-ophthalmic sarcoidosis.: We conducted a multicenter retrospective study on patients with neuro-ophthalmic sarcoidosis. Read More

Spinal Cord Ser Cases 2020 11 2;6(1):99. Epub 2020 Nov 2.

Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Aurora, CO, USA.

Introduction: Sarcoidosis affects the nervous system in ~5-10% of cases. Common presentations for neurosarcoidosis can include facial nerve neuropathy, optic neuritis, meningitis, seizure muscle weakness, and paresthesia. Due to the complex treatment of neurosarcoidosis, few reports exist involving patients' recovery in an acute rehabilitation setting. Read More

J Neuroophthalmol 2020 Oct 26. Epub 2020 Oct 26.

Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.

Background: Sarcoidosis is an idiopathic, multisystem, inflammatory disease that has central nervous system involvement in 5%-15% of cases. The presentation of neurosarcoidosis is highly variable, and the MRI findings often mimic the appearance of other central nervous system diseases. Therefore, the diagnosis can be challenging. Read More

Biomolecules 2020 10 12;10(10). Epub 2020 Oct 12.

Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer 5265601, Israel.

Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) was first introduced in 2011 by Shoenfeld et al. and encompasses a cluster of related immune mediated diseases, which develop among genetically prone individuals as a result of adjuvant agent exposure. Since the recognition of ASIA syndrome, more than 4400 documented cases have been reported so far, illustrated by heterogeneous clinical manifestations and severity. Read More

Ital J Dermatol Venerol 2021 Apr 9;156(2):261-263. Epub 2020 Oct 9.

Department of Dermatology, S. Maria Loreto Nuovo Hospital, Naples, Italy.

Orbit 2020 Sep 10:1-6. Epub 2020 Sep 10.

Ophthalmology Department, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal.

A 59-year-old female patient was diagnosed with Whipple's disease (WD) after several months of constitutional complaints and adenopathies that were initially misinterpreted as sarcoidosis. Initial treatment included doxycycline, hydroxychloroquine and prednisolone, which was suspended due to long-term clinical stability. Four months after prednisolone suspension, the patient presented with right periorbital oedema and erythema. Read More

BMC Ophthalmol 2020 Aug 27;20(1):348. Epub 2020 Aug 27.

Department of Ophthalmology, Eye Ear Nose and Throat Hospital, Fudan University, 83 Fenyang Road, Shanghai, 200031, China.

Background: Neurosarcoidosis is a rare systemic disorder that can affect the eye and other organs, including the central nervous system. Neurosarcoidosis infiltrating the optic nerve presenting as central retinal vein occlusion combined with artery ischaemia has not been reported in the literature previously. We describe a Chinese patient presenting with acute monocular vision loss, in whom an optic nerve biopsy confirmed the diagnosis of neurosarcoidosis. Read More

Semin Respir Crit Care Med 2020 Oct 10;41(5):673-688. Epub 2020 Aug 10.

Department of Internal Medicine, Hopital de la Croix-Rousse, Université Claude Bernard Lyon I, Lyon, France.

Sarcoidosis is one of the leading causes of inflammatory eye disease. Any part of the eye and its adnexal tissues can be involved. Uveitis and optic neuropathy are the main manifestations, which may require systemic treatment. Read More

Semin Respir Crit Care Med 2020 Oct 10;41(5):641-651. Epub 2020 Aug 10.

ILD Care Foundation Research Team, Ede, The Netherlands.

Neurosarcoidosis (NS) is an often severe, destructive manifestation with a likely under-reported prevalence of 5 to 15% of sarcoidosis cases, and in its active phase demands timely treatment intervention. Clinical signs and symptoms of NS are variable and wide-ranging, depending on anatomical involvement. Cranial nerve dysfunction, cerebrospinal parenchymal disease, aseptic meningitis, and leptomeningeal disease are the most commonly recognized manifestations. Read More

Brain Nerve 2020 Aug;72(8):855-862

Department of Neurology and Clinical Neuroscience, Yamaguchi University Graduate School of Medicine.

Sarcoid neuropathy has a broader spectrum of clinical features than previously expected. It is typically characterized by multiple mononeuropathy but often shows a polyneuropathy pattern, making it difficult to be differentiated from other neuropathies. In the diagnostic process, several clinical features, including laterality and proximal-predominance of symptoms at extremities, sensory deficits in the territory of the branch of the peripheral nerve trunk, and positive neuropathic sensory symptoms typically accompanied by pain, could be the cues to evaluate the probability of sarcoid neuropathy. Read More

Neurol India 2020 May-Jun;68(3):609-616

Department of Pathology, AFMC, Pune, Maharashtra, India.

Background: Sarcoidosis is an inflammatory granulomatous disease affecting multiple organ systems. Neurological manifestations are rare and seen in approximately 5% cases of sarcoidosis. They may commonly precede the diagnosis of sarcoidosis. Read More

Semin Respir Crit Care Med 2020 Oct 24;41(5):716-732. Epub 2020 Jun 24.

Division of Pulmonary, Critical Care and Sleep Medicine, Brody School of Medicine, East Carolina University, Greenville, North Carolina.

Health-related quality of life (HRQoL) describes an individual's perception of the impact of health, disease, and treatment on their quality of life (QoL). It is a reflection of how the manifestation of an illness and its treatment is personally experienced. Assessing HRQoL is particularly important in sarcoidosis because the attributable disease mortality is relatively low, and one of the major reasons for initiating treatment is to improve quality of life. Read More

Med Clin (Barc) 2020 10 18;155(7):309-312. Epub 2020 Jun 18.

Servicio de Neurología, Hospital Virgen de la Victoria, Málaga, España. Electronic address:

Introduction: Neurosarcoidosis is a rare complication of sarcoidosis. There are small series on the condition and very few from Spain. We conducted a retrospective study of neurosarcoidosis in Virgen de la Victoria Hospital over the last 10 years. Read More

Continuum (Minneap Minn) 2020 06;26(3):695-715

Purpose Of Review: This article provides an overview and update on the neurologic manifestations of sarcoidosis.

Recent Findings: The 2018 Neurosarcoidosis Consortium diagnostic criteria emphasize that biopsy is key for diagnosis and determines the level of diagnostic certainty. Thus, definite neurosarcoidosis requires nervous system biopsy and probable neurosarcoidosis requires biopsy from extraneural tissue. Read More

Neurohospitalist 2020 Apr 24;10(2):118-120. Epub 2019 Jul 24.

Department of Neurology, School of Medicine, Washington University in St Louis, St Louis, MO, USA.

Clinical diagnosis often focuses on identifying the single cause of a patient's symptoms but it is becoming increasingly recognized that a subset of patients exist where 2 pathological entities coexist. These patients present a particular diagnostic challenge because the first "positive" diagnostic test is not the definitive stopping point in their evaluation. Here, we present the case of a 47-year-old woman with multiple cranial neuropathies and a polyradiculopathy. Read More

Clin Neurol Neurosurg 2020 07 20;194:105811. Epub 2020 Mar 20.

Centre for Neurosarcoidosis, Neuroimmunology Unit, Institute of Immunity and Transplantation, University College London, London, NW3 2PF, United Kingdom. Electronic address:

Objectives: Neurological complications of sarcoidosis are uncommon and the natural history and optimal treatments under-researched. With the advent of biological therapies, it is important to define the clinical characteristics and immunopathology of the disease.

Patients And Methods: Patients referred to and treated within the Centre for Neurosarcoidosis over a 15 year period who had biopsy proven "highly probable" disease of the central nervous system were studied prospectively. Read More

Retin Cases Brief Rep 2020 Feb 13. Epub 2020 Feb 13.

Ophthalmology Department, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio.

Background/purpose: To report a case of unilateral choroidal detachment and serous retinal detachment in a patient with a history of untreated sarcoidosis.

Methods: Case report. The patient is a 67-year-old African American man with a history of nontreated sarcoidosis and prostate cancer. Read More