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Sarcoidosis

Can Sarcoidosis Cause Neurological Problems?

11/29/2011

Question:

As a person with Sarcoidosis for many years it is so frustrating dealing with Physicians who are lacking in their knowledge of the condition. I had a spinal fluid test and no Sarcoidosis was found. However, I am suffering from Seizures that are difficult to diagnosis and locate a cause. At the present time, my symptoms would identify that I have Partial Complex Seizures although the EEG is normal and I am being told it could be due to stress. Well, dealing with the Medical community is stressful in itself. My question is although the spinal fluid is negative for Sarcoidosis, is it still possible that the Sarcoidosis is causing Neurologic problems? I have had the condition for 31 years and seizure symptoms since 2004, but no one paid any attention until I experienced a blackout while driving in 2009. Since 2009 I have the additional symptom of blackouts that last 5-10 minutes.

Answer:

Dear Sir/Madam- Sarcoidosis can involve the central nervous system (a.k.a., neurosarcoidosis), and is a known cause of seizures.
 
Most cases of neurosarcoidosis associated with seizures are associated with abnormalities discovered while imaging the brain.

MRI scanning is very sensitive for the detection of neurosarcoidosis. Lumbar puncture (spinal tap) is abnormal in about 2/3 of cases. However, lumbar puncture findings cannot confirm or exclude the diagnosis.

The only way to confirm the diagnosis is to perform a biopsy of the affected tissue (brain, spinal cord, or the lining of the brain). Because most patients and doctors are reluctant to biopsy the brain, the diagnosis of neurosarcoidosis is often presumptive (based upon circumstantial evidence).

For instance, a person presenting with unexplained neurological findings (abnormal MRI findings, unexplained seizures, etc.) in the setting of confirmed sarcoidosis outside of the brain would increase the doctor's suspicion of neurosarcoidosis.

For more information:

Go to the Sarcoidosis health topic, where you can:

Response by:

Elliott D Crouser, MD Elliott D Crouser, MD
Associate Professor of Pulmonary, Allergy, Critical Care & Sleep Medicine
College of Medicine
The Ohio State University