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This case report describes a woman in her late 50s with stroke-like neurologic symptoms, initially negative stroke evaluation, and imaging revealing mediastinal lymphadenopathy and mitral regurgitation. Lumbar puncture supported neurosarcoidosis; steroid therapy improved symptoms, after which non-sustained ventricular tachycardia led to further findings consistent with cardiac sarcoidosis. An implantable cardioverter-defibrillator was placed, with continued immunosuppressive treatment yielding favorable outcomes.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/concomitant-neurosarcoidosis-and-cardiac-sarcoidosis-a-peculiar-path-to-diagnosis/452403/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/concomitant-neurosarcoidosis-and-cardiac-sarcoidosis-a-peculiar-path-to-diagnosis/452403.png","ImageObject",300,407,{"name":92,"@type":93},"A glass of water","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-01","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",13,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"Why is diagnosing systemic sarcoidosis in this case challenging?","Question",{"text":113,"@type":114},"Sarcoidosis has variable, nonspecific presentations that may masquerade as isolated pathologies. Difficulty increases when uncommon organs such as the brain and heart are involved.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What initial findings suggested a stroke-like presentation but did not confirm stroke?",{"text":118,"@type":114},"The patient presented with facial droop, aphasia, and headache, and head CT showed no hemorrhage or infarct. Brain MRI also showed no mass, edema, hydrocephalus, shift, or restricted diffusion.",{"name":120,"@type":111,"acceptedAnswer":121},"How did the diagnosis progress from neurosarcoidosis to concurrent cardiac sarcoidosis?",{"text":122,"@type":114},"Lumbar puncture findings supported neurosarcoidosis and symptoms improved after steroid initiation. Later, non-sustained ventricular tachycardia prompted further evaluation that revealed findings consistent with cardiac sarcoidosis, leading to ICD placement.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},452403,1790765754,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":29,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},962090760832,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","e-ISSN 1941-5923  \n© Am J Case Rep, 2025; 26: e950208 DOI: 10. 12659/AJCR.950208  \nReceived: 2025.06.10  \nAccepted: 2025.10.28  \nAvailable online: 2025.11.17  \nPublished: 2025.12.19  \nAuthors’ Contribution: Study Design A  \nData Collection B Statistical Analysis C Data Interpretation D Manuscript Preparation E Literature Search F Funds Collection G  \nEF 1  \nE 2  \nCorresponding Author: Financial support: Conflict of interest:  \nConcomitant Neurosarcoidosis and Cardiac Sarcoidosis: A Peculiar Path to Diagnosis  \nMeghan Stevenson Naveed Younis  \nMeghan Stevenson, [e-mail:](e-mail: mstevenson@sbrmc.org)[ mstevenson@sbrmc.org](e-mail: mstevenson@sbrmc.org)  \nNone declared  \nNone declared  \n1 Internal Medicine Program, St. Bernards Medical Center, Jonesboro, AR, USA  \n2 Department of Cardiology, St. Bernards Medical Center, Jonesboro, AR, USA  \nPatient: Female, 59-year-old  \nFinal Diagnosis: Neurosarcoidosis  \nSymptoms: Aphasia • facial droop • headache  \nClinical Procedure: —  \nSpecialty: Cardiology • General and Internal Medicine • Neurology • Rheumatology  \nObjective: Unusual clinical course  \nBackground: Sarcoidosis is a multisystem inflammatory disorder characterized by non-caseating granulomas. Although the disease most commonly affects the respiratory and lymphatic systems, extrapulmonary manifestations involving the brain and heart also occur. Neurosarcoidosis may cause dysfunction of the cranial nerves, meninges, peripheral nerves, or the pituitary system. Cardiac sarcoidosis may lead to arrhythmias, cardiomyopathy, or heart failure. These specific diagnoses can be challenging because they may masquerade as isolated pathologies. In this clinical vignette, we present a rare case of systemic sarcoidosis with concomitant neurological and cardiac involvement.  \nCase Report: A woman in her late 50s with a history of bilateral anterior uveitis presented with stroke-like symptoms. Initial workup was negative for stroke, but imaging identified a prevascular mediastinal lymph node and moderate mitral regurgitation. Lumbar puncture results were consistent with neurosarcoidosis, and steroids initiation led to symptom improvement. The patient subsequently exhibited non-sustained ventricular tachycardia, and further investigation revealed findings consistent with cardiac sarcoidosis. An implantable cardioverter-defibrillator was placed. The patient continued steroids and immunosuppressive therapy with favorable results.  \nConclusions: Diagnosis of systemic sarcoidosis can be difficult because of its variable presentation. This challenge is enhanced when uncommon organs such as the brain and heart are affected. Thorough evaluation is therefore essential when evaluating systemic diseases.  \nKeywords: Cardiology • Neurology • Sarcoidosis  \nFull-text PDF: [https://www.amjcaserep.com/abstract/index/idArt/950208](https://www.amjcaserep.com/abstract/index/idArt/950208)  \nPublisher’s note: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher  \nThis work is licensed under Creative Common AttributionNonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)  \ne950208-1  \nIndexed in: [PMC] [PubMed] [Emerging Sources Citation Index (ESCI)][Web of Science by Clarivate]  \nStevenson M. and Younis N.:  \nConcomitant neurosarcoidosis and cardiac sarcoidosis © Am J Case Rep, 2025; 26: e950208  \nIntroduction  \nSarcoidosis is a multisystem disease that most commonly affects the lymphatic and pulmonary systems, although organs such as the heart and brain may also be involved. Diagnosis of extrapulmonary disease is challenging because symptoms are often nonspecific and mimic other conditions, which may result in prolonged evaluation, delayed treatment, and worse outc","cbCaikbzLqPqq9om","https://ap.wps.com/l/cbCaikbzLqPqq9om","pdf",1816844,"English","# Introduction\n# Case Report","[{\"question\":\"Why is diagnosing systemic sarcoidosis in this case challenging?\",\"answer\":\"Sarcoidosis has variable, nonspecific presentations that may masquerade as isolated pathologies. Difficulty increases when uncommon organs such as the brain and heart are involved.\"},{\"question\":\"What initial findings suggested a stroke-like presentation but did not confirm stroke?\",\"answer\":\"The patient presented with facial droop, aphasia, and headache, and head CT showed no hemorrhage or infarct. Brain MRI also showed no mass, edema, hydrocephalus, shift, or restricted diffusion.\"},{\"question\":\"How did the diagnosis progress from neurosarcoidosis to concurrent cardiac sarcoidosis?\",\"answer\":\"Lumbar puncture findings supported neurosarcoidosis and symptoms improved after steroid initiation. Later, non-sustained ventricular tachycardia prompted further evaluation that revealed findings consistent with cardiac sarcoidosis, leading to ICD placement.\"}]","Concomitant Neurosarcoidosis and Cardiac Sarcoidosis - A Peculiar Path to Diagnosis | PDF",1790737052,15]