Neurosarcoidosis Treatment
Antibiotics have not been proven to be of benefit. Immunosuppression primarily with corticosteroids is beneficial for systemic as well as neurologic involvement. Therapy may be initiated with prednisone 60 mg PO QD in adults and tapered based on response. Therapy with cyclosporine may allow a reduction in steroid dosage in refractory cases 1).
Treatment options for unresponsive cases include methotrexate, Cytoxan, cyclophosphamide, azathioprine, Hydroxychloroquine (Plaquenil®) & low dose XRT. CSF shunting is indicated if hydrocephalus develops.
1)
Stern BJ, Schonfeld SA, Sewell C, et al. The Treatment of Neurosarcoidosis With Cyclosporine. Arch Neurol. 1992; 49:1065–1072