In a recently published article, Lower et al1 describe their "experience of the manifestations, clinical outcome, and treatment regimens in patients with neurological sarcoidosis." Their definition of neurosarcoidosis includes "non-caseating granulomas in neurological tissue" as well as neurological abnormalities in patients diagnosed as having nonneurological sarcoidosis. However, the authors neglect to include in their criteria for neurosarcoidosis the presence of evoked potential abnormalities. Several studies have documented visual, auditory, and/or somatosensory evoked potential abnormalities in patients with neurosarcoidosis.2- 6 In one of these studies, 5 of 12 patients had evoked potential abnormalities in the absence of clinical signs of neurosarcoidosis.6 This suggests that neurosarcoidosis may be subclinical and more common than would otherwise be assumed. I would suggest that studies evaluating the response of neurosarcoidosis to treatment include an assessment of multimodality evoked potential abnormalities and the evolution of such abnormalities with treatment.
Simon MR. Multimodality Evoked Potentials in the Diagnosis and Management of Neurological Sarcoidosis. Arch Intern Med. 1998;158(9):1036. doi: