Journal article
Neurosarcoidosis mimicry of MS: Clues from cases with CNS tissue diagnosis
Journal of the neurological sciences, v 429, 117621
15 Oct 2021
PMID: 34455208
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
The clinical picture of neurosarcoidosis (NS) shares many aspects with multiple sclerosis (MS). I examine whether or not clinical measures can reliably distinguish NS mimicking MS from NS coexisting with MS, and the informative role biopsy and autopsy evidence may play in understanding these two disorders. Uniquely challenging, I explore the rare patients presenting with the differential of MS or acute disseminated encephalomyelitis (ADEM) versus NS, including MS or ADEM as an associated illness in patients with systemic sarcoidosis. In most but not all NS patients, red flags against a diagnosis of MS are strong enough to rule out this more common disorder. Biopsy and autopsy findings indicate a tendency of NS granulomatous changes in the CNS to involve the same deep white matter perivascular spaces as expected to occur in MS, and hence correlate with a tendency of NS involving white matter to produce classic MRI findings of MS. The spectrum of NS includes some cases limited to a single anatomical site, including sites classically involved in demyelinating CIS (optic nerve, brainstem, and transverse myelitis). Asymptomatic “non-specific” periventricular MRI changes are described in many studies as “MS-like”. No biopsied or autopsied cases have yet proven associated classic pathological changes of MS in patients with NS.
•The clinical and radiographic overlap between neurosarcoidosis (NS) and multiple sclerosis (MS) has been described for 3 decades.•The strength of the evidence for a coexistence of both disorders in rare cases is weak.•Autopsied cases support NS as a potential mimic of MS.•NS and MS do not coexist at the biopsy or autopsy level.•MRI scanning is often useful in distinguishing NS from MS.
Metrics
Details
- Title
- Neurosarcoidosis mimicry of MS: Clues from cases with CNS tissue diagnosis
- Creators
- Thomas F. Scott - Allegheny General Hospital
- Publication Details
- Journal of the neurological sciences, v 429, 117621
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Neurology
- Web of Science ID
- WOS:000714609400024
- Scopus ID
- 2-s2.0-85113692825
- Other Identifier
- 991019167552604721
UN Sustainable Development Goals (SDGs)
This publication has contributed to the advancement of the following goals:
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Clinical Neurology
- Neurosciences