Brain sarcoidosis is a complex disease and its treatment in modern medicine is based on dealing with the symptoms, rather then addressing the causes which remain obscure. In sarcoidosis, the immune system is activated to fight a non-existent enemy, hence the name autoimmune.
This is an article that will be looking into the involvement of the Central Nervous System in sarcoidosis or Neurosarcoidosis.
Sarcoidosis may affect any part of our brain. CNS involvement occurs in 2-7% of patients. One of the most common symptoms in those affected by neurosarcoidosis is facial weakness (if the disease affects the nerves of the face). It can also cause distortions in the ways our senses function (hearing, taste …).
One of the worst implications is the involvement of hypothalamus, which regulates our body weight, body temperature and sleep.
Brain sarcoidosis diagnosis
Neurosarcoidosis is the most difficult to diagnose, because of the inaccessibility and the risk of biopsies of CNS lesions. That is why MRI scans are the first choice in health practitioners looking into brain involvement in sarcoidosis.
Brain sarcoidosis manifestations
Common manifestations of brain sarcoidosis include: Meningitis, Seizures, Cerebellar ataxia (loss of coordination), Psychiatric symptoms, Decreased hearing, Speech impairment, Loss of sense of smell, Dementia or delirium, Dizziness or vertigo (abnormal sensation of movement), Papilledema ( optical disc swelling).
Brain Sarcoidosis – Optic nerve
This is the second most commonly hidden cranial nerve in sarcoidosis (after the facial nerve). Optic nerve lesion occurs in 5% of patients with brain sarcoidosis. Visual symptoms of optic nerve involvement include blurred vision, field defects, and pupillary abnormalities. Examination of the optical fundi reveals characteristic sarcoid changes, including edema of the disc, optic neuritis, and optic atrophy secondary to granulomatous infiltration in brain sarcoidosis.
Brain sarcoidosis and the spinal cord
There are no rules to what part of the spinal cord can be involved in sarcoidosis. Clinical signs of spinal cord dysfunction include: paraparesis (weakness of the lower extremitudes), tetraparesis (weakness of all four limbs), back and leg pains, incontinence (inability to control excretory functions).