Neurosarcoidosis With Extensive Opto-Chiasmatic and Meningeal Involvement: A Case Report

Neurosarcoidosis, a rare neurological manifestation of systemic sarcoidosis, poses significant diagnostic challenges due to its nonspecific clinical presentation and variable imaging features. We report the case of a 64-year-old female presenting with progressive visual disturbances and multifocal neurological deficits. Magnetic resonance imaging (MRI) revealed extensive opto-chiasmatic involvement, diffuse nodular leptomeningeal enhancement, and cranial nerve inflammation, consistent with neurosarcoidosis. This case underscores the indispensable role of advanced neuroimaging in delineating disease extent, guiding biopsy, and monitoring therapeutic response. Early recognition of characteristic MRI patterns, combined with multidisciplinary collaboration, is critical to prevent irreversible neurological damage and optimize patient outcomes.