The Burden of Neurosarcoidosis
| Autor: | Marjolein Drent, Barney J. Stern, Lesley Ann Saketkoo, Mareye Voortman |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
cognition medicine.medical_specialty peripheral neuropathy small fiber neuropathy Disease paralysis Critical Care and Intensive Care Medicine FATIGUE BRONCHOALVEOLAR LAVAGE 03 medical and health sciences 0302 clinical medicine EVERYDAY COGNITIVE FAILURE LONG-TERM OUTCOMES Central Nervous System Diseases QUALITY-OF-LIFE medicine Paralysis Humans SMALL-FIBER NEUROPATHY sarcoidosis Intensive care medicine Physical Therapy Modalities CNS SARCOIDOSIS neurosarcoidosis business.industry CENTRAL-NERVOUS-SYSTEM Aseptic meningitis Neurosarcoidosis medicine.disease Magnetic Resonance Imaging Review article Early Diagnosis Peripheral neuropathy 030228 respiratory system CORNEAL CONFOCAL MICROSCOPY Quality of Life Biomarker (medicine) SKIN BIOPSY Sarcoidosis medicine.symptom business Biomarkers Immunosuppressive Agents 030217 neurology & neurosurgery |
| Zdroj: | Seminars in Respiratory and Critical Care Medicine. 41(05):641-651 |
| ISSN: | 1069-3424 |
| DOI: | 10.1055/s-0040-1710576 |
| Popis: | Neurosarcoidosis (NS) is an often severe, destructive manifestation with a likely under-reported prevalence of 5 to 15% of sarcoidosis cases, and in its active phase demands timely treatment intervention. Clinical signs and symptoms of NS are variable and wide-ranging, depending on anatomical involvement. Cranial nerve dysfunction, cerebrospinal parenchymal disease, aseptic meningitis, and leptomeningeal disease are the most commonly recognized manifestations. However, non-organ-specific potentially neurologically driven symptoms, such as fatigue, cognitive dysfunction, and small fiber neuropathy, appear frequently.Heterogeneous clinical presentations and absence of any single conclusive test or biomarker render NS, and sarcoidosis itself, a challenging definitive diagnosis. Clinical suspicion of NS warrants a thorough systemic and neurologic evaluation hopefully resulting in supportive extraneural physical exam and/or tissue findings. Treatment targets the severity of the manifestation, with careful discernment of whether NS reflects active potentially reversible inflammatory granulomatous disease versus inactive postinflammatory damage whereby functional impairment is unlikely to be pharmacologically responsive. Non-organ-specific symptoms are poorly understood, challenging in deciphering reversibility and often identified too late to respond to conventional immunosuppressive/pharmacological treatment. Physical therapy, coping strategies, and stress reduction may benefit patients with all disease activity levels of NS.This publication provides an approach to screening, diagnosis, disease activity discernment, and pharmacological as well as nonpharmacological treatment interventions to reduce disability and protect health-related quality of life in NS. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|