Neurosarcoidosis

Sarcoidosis is a rare inflammatory condition in which clusters of immune cells (granulomas) form in various organs of the body — most commonly the lungs, lymph nodes, and skin. In around 5% to 15% of cases, sarcoidosis affects the central or peripheral nervous system, a complication known as neurosarcoidosis.

At The Royal Buckinghamshire Hospital, we specialise in supporting adult patients with neurological complications of systemic illnesses like sarcoidosis. Our inpatient neurorehabilitation programmes are designed to help patients recover function, manage symptoms, and regain independence.

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What Is Neurosarcoidosis?

Neurosarcoidosis occurs when granulomas or inflammation affect:

• The brain (cerebral sarcoidosis)
• The spinal cord
• The cranial nerves (especially facial nerve palsy)
• The meninges (the protective layers around the brain and spine)
• The peripheral nerves (neuropathy)

Because of its varied presentation, neurosarcoidosis is often mistaken for multiple sclerosis, stroke, meningitis, or brain tumours, making accurate diagnosis challenging.

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Neurological Symptoms of Neurosarcoidosis

Symptoms depend on which part of the nervous system is involved, but may include:

• Facial weakness or facial droop (cranial nerve VII involvement)
• Seizures or new-onset epilepsy
• Headaches and visual changes
• Weakness or numbness in the arms or legs
• Coordination or balance problems
• Confusion or cognitive difficulties
• Fatigue or excessive sleepiness
• Bladder or bowel changes (in spinal cord involvement)

In some patients, neurosarcoidosis can increase the risk of stroke-like episodes, particularly if blood vessels become inflamed (vasculitis).

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Causes and Risk Factors

The exact cause of sarcoidosis is unknown, but it is believed to involve an abnormal immune response. Contributing factors may include:

• Genetic predisposition
• Environmental exposure (e.g. dusts or chemicals)
• Viral or bacterial triggers
• Immune system dysregulation

Neurosarcoidosis may appear early in the disease or years after initial diagnosis.

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Diagnosis and Referral

Diagnosis is typically made through a combination of:

• MRI brain or spine scans
• Lumbar puncture (CSF analysis)
• Blood tests and inflammatory markers
• Biopsy of other affected organs
• Neurology and rheumatology input

Patients may be referred to rehabilitation following hospitalisation or once long-term treatment (e.g. steroids or immunosuppressants) has stabilised the inflammatory process.

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Rehabilitation at The Royal Buckinghamshire Hospital

Neurosarcoidosis can leave lasting effects on the brain, spinal cord, or peripheral nerves, even after inflammation is treated. At Royal Bucks, we help patients manage:

• Movement problems
• Chronic fatigue
• Speech and language changes
• Pain or neuropathy
• Cognitive and mood changes
• Reduced mobility or confidence

Our multidisciplinary approach includes:

• Neurophysiotherapy
• Occupational therapy
• Speech and language therapy
• Neuropsychology and fatigue management
• Pain management support
• Spasticity treatment (if required)

Explore Our Rehabilitation Centre
Learn About Neuroinflammation
See Post-Stroke Rehab Pathways