Presumptive isolated neurosarcoidosis involving eloquent structures: An argument for empirical TNF-α inhibition

J Neuroimmunol. 2022 Nov 15;372:577956. doi: 10.1016/j.jneuroim.2022.577956. Epub 2022 Aug 28.


There are clinical and radiological phenotypes characteristic of neurosarcoidosis. Histopathologic confirmation is preferred, however, biopsy is associated with a significant risk of morbidity when only eloquent neural structures are involved and where there is no systemic disease. We present a series of patients with isolated neurosarcoidosis and suggest circumstances where an empirical, closely monitored, trial of tumour-necrosis-factor-alpha inhibitor therapy can improve outcome and diagnostic confidence.

Keywords: Empirical; MRI compatible; Myelitis; Neurosarcoidosis; Optic neuritis; Tumour-necrosis-factor-α inhibitor.

MeSH terms

  • Central Nervous System Diseases* / complications
  • Central Nervous System Diseases* / diagnostic imaging
  • Central Nervous System Diseases* / drug therapy
  • Humans
  • Inhibition, Psychological
  • Sarcoidosis* / diagnostic imaging
  • Sarcoidosis* / drug therapy
  • Tumor Necrosis Factor-alpha


  • Tumor Necrosis Factor-alpha

Supplementary concepts

  • Neurosarcoidosis