Rinsho Shinkeigaku (Clinical Neurology)

The 46th Annual Meeting of the Japanese Society of Neurology

Diagnostic criteria of neurosarcoidosis

Manabu Sakuta, M.D.1), Toshihide Kumamoto, M.D.2), Takahiro Iizuka, M.D.3), Kazutoshi Nishiyama, M.D.1) and Masaru Oritsu, M.D.4)

1)Dpt Neurology, Kyorin University, 2)Department Neurology Ooita University,
3)Dpt Neurology Kitasato University, 4)Dpt Respiratory Medicine Japanese Red Cross Medical Center

We have collaborated with Japanese Sarcoidosis Society and Japanese Society of Respiratory diseases to make a new diagnostic criteria of neurosarcoidosis.
(definite) Having positive clinical findings which suggest a neurosarcoidosis.
Pathology proven case.
(probable) Having positive clinical findings which suggest a neurosarcoidosis.
Pathology proven in other organ.
Elevated serum ACE or BHL demonstrated by chest XP or CT scan.
(possible) Having positive clinical findings which suggest a neurosarcoidosis.
Elevated serum ACE or BHL demonstrated by chest XP or CT scan. CNS sarcoidosis, sarcoid neuropathy and sarcoid myopathy are separately diagnosed.
To evaluate our criteria, about 100 papers on neurosarcoidosis published worldwide in these 6 years were retrospectively examined. Our criteria showed a better results than 1988 criteria (former Japanese criteria) and Zajicek's criteria which was published in 1999 (QJ Med 92: 103).
Point is there is no more need to depend upon Kveim reaction which is time consuming, not so specific and difficult to obtain its antigen.
Our new criteria is calculated to be sensitivity of 78-98% (BHL or ACE), and specificity of 83-99% (ACE). Because of their low specificity, Gallium scintigraphy and broncho alveolar lavage fluid examination are excluded from our diagnostic criteria, however, their high sensitivity are still useful to begin with.

(CLINICA NEUROL, 45: 837－840, 2005)
key words: neurosarcoidosis, CNS sarcoidosis, sarcoid neuropathy, sarcoid myopathy (muscular sarcoidosis), diagnostic criteria

(Received: 27-May-05)