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Cureus 2022 May 16;14(5):e25047. Epub 2022 May 16.

Neurology, Aga Khan Health Service, Karachi, PAK.

Background The etiology of facial nerve palsy is diverse and includes herpes zoster virus, Guillain-Barre syndrome (GBS), otitis media, Lyme disease, sarcoidosis, human immunodeficiency virus, etc. The lower motor neuron type facial nerve palsy is usually caused by an ipsilateral facial nerve lesion; however, it may be caused by a central lesion of the facial nerve nucleus and tract in the pons. Facial diplegia is an extremely rare condition that occurs in approximately 0. Read More

Rinsho Shinkeigaku 2022 May 28. Epub 2022 May 28.

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

A 72-year old woman, who had a history of psoriasis and psoriatic arthritis from age of 69, was admitted because of acute progression of dyspnea and generalized muscle weakness after initiation of ustekinumab. She had been diagnosed as having lung and eye sarcoidosis ten months before admission. Nerve conduction studies revealed multiple mononeuropathy and needle electromyography showed myogenic changes with spontaneous activities. Read More

Eye (Lond) 2022 May 24. Epub 2022 May 24.

Department of Ophthalmology, Auckland District Health Board, Auckland, New Zealand.

Background: To examine risk factors for development of glaucoma in a large cohort of subjects with uveitis and scleritis.

Methods: Retrospective review of subjects diagnosed with uveitis or scleritis between 2006 and 2019 at Auckland District Health Board. Subjects were excluded if they had glaucoma due to another cause. Read More

J Neuroimmunol 2022 Jul 9;368:577864. Epub 2022 Apr 9.

Division of Neurology, National Jewish Health, Department of Medicine, 1400 Jackson Street, Denver, CO 80209, USA. Electronic address:

Peripheral nerve disorders in sarcoidosis consist of granulomatous neuropathy and non-granulomatous small fiber neuropathy (SFN), which differ in their underlying pathology, diagnostic methods and treatment. While granulomatous nerve involvement is rare in sarcoidosis, SFN is reported in over 40% of systemic cases. Distal symmetric polyneuropathy and asymmetric polyradiculoneuropathy are the most common presentations of granulomatous neuropathy, which typically responds to corticosteroids. Read More

J Neurol 2022 May 18. Epub 2022 May 18.

Department of Neurology, Emory University School of Medicine, 12 Executive Park Drive NE, Atlanta, GA, 30329, USA.

Background: Facial nerve palsy is a cardinal manifestation of neurosarcoidosis, but dedicated studies of this disease feature have not been conducted. We sought to clarify the impact of facial palsy on the diagnosis of neurosarcoidosis, its subsequent clinicoradiographic evolution, and eventual treatment decisions.

Methods: A single-center retrospective analysis of patients with neurosarcoidosis and facial palsy was conducted over the preceding 10 years (01/01/2011-08/12/2021). Read More

Dermatol Ther (Heidelb) 2022 May 17;12(5):1103-1119. Epub 2022 Apr 17.

Department of Dermatology, University Hospital Centre, CHU du Sart Tilman, University of Liège, 4000, Liège, Belgium.

Introduction: Non-dermatology medical specialties may refer patients for skin biopsies, searching for a particular diagnosis. However, the diagnostic impact of the skin biopsy is not clearly established. This article aims to assess the indications for, and evaluate the clinical relevance of, skin biopsies in non-dermatology medical specialties. Read More

Neurohospitalist 2022 Apr 7;12(2):290-294. Epub 2022 Feb 7.

Department of Internal Medicine and Clinical Immunology, CHU Bordeaux (Groupe Hospitalier Saint-André), University of Bordeaux, Bordeaux, France.

Neurological involvement occurs in 5 to 15% of patients with sarcoidosis. It rarely represents the sole manifestation of the disease, a condition called isolated neurosarcoidosis.

Objectives: To describe patients with definite isolated central neurosarcoidosis. Read More

Pathophysiology 2021 Dec 26;29(1):1-8. Epub 2021 Dec 26.

Laboratory Mosaic Autoimmunity, St. Petersburg State University, 199304 St. Petersburg, Russia.

Chronic pain may affect 30-50% of the world's population and an important cause is small fiber neuropathy (SFN). Recent research suggests that autoimmune diseases may be one of the most common causes of small nerve fiber damage. There is low awareness of SFN among patients and clinicians and it is difficult to diagnose as routine electrophysiological methods only detect large fiber abnormalities, and specialized small fiber tests, like skin biopsy and quantitative sensory testing, are not routinely available. Read More

Pathophysiology 2021 Dec 20;28(4):544-550. Epub 2021 Dec 20.

Laboratory of the Mosaic of Autoimmunity, Saint-Petersburg State University, 199034 Saint-Petersburg, Russia.

Sarcoidosis (SC) is a granulomatous disease of an unknown origin. The most common SC-related neurological complication is a small fiber neuropathy (SFN) that is often considered to be the result of chronic inflammation and remains significantly understudied. This study aimed to identify the clinical and histological correlates of small fiber neuropathy in sarcoidosis patients. Read More

Cureus 2022 Feb 6;14(2):e21966. Epub 2022 Feb 6.

Oculoplastic, Orbital and Lacrimal Surgery, Aichi Medical University Hospital, Nagakute, JPN.

A 74-year-old woman had a six-month history of decreased vision in the left eye. On the first examination, her left best-corrected visual acuity was 0.02, and Goldmann visual field test revealed a central scotoma in the left eye. Read More

Am J Ophthalmol Case Rep 2022 Jun 25;26:101451. Epub 2022 Feb 25.

CHU St Pierre, Ophthalmology, Brussels, Belgium.

Purpose: Ocular disease can be the initial manifestation in patients with sarcoidosis. It is most often associated with uveitis, but eyelid or optic nerve disease can also be presenting features. Although uncommon and easy to overlook in a patient presenting with visual loss, paying attention to the presence of eyelid granulomas in our patient proved to be very helpful in our diagnostic work up for optic neuropathy. Read More

Semin Neurol 2021 12 26;41(6):673-685. Epub 2021 Nov 26.

Department of Neurology, Johns Hopkins University, Baltimore, Maryland.

Facial palsy is a common neurologic concern and is the most common cranial neuropathy. The facial nerve contains motor, parasympathetic, and special sensory functions. The most common form of facial palsy is idiopathic (Bell's palsy). Read More

Int Ophthalmol 2022 Feb 21;42(2):689-711. Epub 2021 Nov 21.

Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", Medical School, Polyclinic, Piazza Giulio Cesare 11, 70124, Bari, Italy.

Purpose: To provide an overview of the ocular features of rheumatoid arthritis (RA) and of the ophthalmic adverse drug reactions (ADRs) that may be associated with the administration of antirheumatic drugs.

Methods: A systematic literature search was performed using the PubMed, MEDLINE, and EMBASE databases. In addition, a cohort of 489 RA patients who attended the Authors' departments were examined. Read More

BMJ Case Rep 2021 Nov 11;14(11). Epub 2021 Nov 11.

Ophthalmology, King's College Hospital NHS Foundation Trust, London, UK.

Sarcoidosis is a systemic, idiopathic and granulomatous disease, which most commonly affects the skin, lungs and lymph nodes but can affect virtually any organ. Neurosarcoidosis can be the presenting or the only clinical manifestation accounting for 5%-15% of sarcoid diagnoses. In contrast to uveitis which is the most common ophthalmic manifestation, neuro-ophthalmic signs are uncommon in sarcoidosis. Read More

Sarcoidosis Vasc Diffuse Lung Dis 2021 30;38(3):e2021022. Epub 2021 Sep 30.

Unit of Dermatology, Department of Medicine DIMED, University of Padua, Padua, Italy.

Leukocytoclastic vasculitis (LCV) is a common form of small-vessel vasculitis, which commonly presents as palpable purpura or petechiae, caused by deposition of circulating immune complexes on vessels walls that attracts granulocytes which damage the vascular endothelium and leading to erythrocytes extravasation. The skin is the most commonly involved organ, but also renal, gastrointestinal, pulmonary, cardiovascular and neurological systems may be affected. Skin lesions may be the initial signs of systemic vasculitis. Read More

Neurohospitalist 2021 Oct 8;11(4):356-359. Epub 2021 Feb 8.

Department of Internal Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL, USA.

Sarcoidosis is an inflammatory disease that presents with nervous system involvement in 5-10% of cases, commonly known as neurosarcoidosis. While there are no randomized controlled trials for the treatment of neurosarcoidosis, expert opinion supports initial treatment with corticosteroids and the use of steroid-sparing or anti-TNF agents in refractory or severe cases. We report a case of a 48-year-old African American male with a past medical history of biopsy-proven hepatic and renal sarcoidosis and progressive headache, dizziness, and blurry vision for 5 months, presenting with an acute exacerbation of right-sided vision loss over one day. Read More

Scand J Gastroenterol 2021 09 2;56(9):1000-1010. Epub 2021 Jul 2.

Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden.

Purpose: Peripheral autonomic neuropathy, including enteric neuropathy, may be subtle and unrecognized for several years. Diagnosis of enteric neuropathy demands complicated examinations such as full-thickness bowel biopsy. We hypothesized that knowledge about simultaneous occurrence of different types of neuropathy would lead to faster recognition and diagnosis of autonomic/enteric neuropathy. Read More

Eur Respir J 2021 12 16;58(6). Epub 2021 Dec 16.

Henry Ford Hospital, Detroit, MI, USA.

Background: The major reasons to treat sarcoidosis are to lower the morbidity and mortality risk or to improve quality of life (QoL). The indication for treatment varies depending on which manifestation is the cause of symptoms: lungs, heart, brain, skin or other manifestations. While glucocorticoids remain the first choice for initial treatment of symptomatic disease, prolonged use is associated with significant toxicity. Read More

Joint Bone Spine 2021 12 31;88(6):105232. Epub 2021 May 31.

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 Nov 21;268(11):4265-4279. 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 05 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 6;26(6):454-460. 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 2021 Jul 30;268(7):2466-2472. Epub 2021 Jan 30.

Oxford University Hospitals NHS Foundation Trust, Headley way, Headington, OX3 9DU, UK.

Introduction: Neurosarcoidosis is associated with a significant degree of morbidity and mortality and its treatments are varied and complex. There is a paucity of information in current literature on patterns of treatment and long term outcomes. This study aimed to evaluate the clinical outcomes and responses to immunosuppressive therapy in a large cohort of neurosarcoidosis patients . 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