Screening for Cochleovestibular Disorders in Neurosarcoidosis: A Study of 21 Patients at the University Hospital Mohammed VI of Marrakech

Introduction: Neurosarcoidosis is a rare condition characterized by the involvement of the nervous system in sarcoidosis, a granulomatous disease. This disorder can present in various forms, including cranial nerve palsies, encephalopathy, and especially, cochleovestibular symptoms. Diagnosis of neurosarcoidosis often poses a challenge, as its clinical manifestations can overlap with other neurological conditions, requiring a thorough diagnostic work-up.
Objective: Evaluation of the cochleovestibular manifestations in neurosarcoidosis, focusing on symptoms like hearing loss, tinnitus, and vertigo, and their correlation with clinical findings, radiological images, and diagnostic results in 21 patients followed in the otolaryngology department at the University Hospital of Marrakech.
Methods: This retrospective study involved 21 patients diagnosed with neurosarcoidosis, who underwent a comprehensive screening for cochleovestibular disorders in the otolaryngology department over a period of three years (from January 2023 to December 2025). Diagnostic methods included pure tone audiometry (PTA) and video nystagmography (VNG).
Results: The study involved 21 patients with diverse presentations of neurosarcoidosis. Audiometric evaluation revealed varying degrees of hearing loss, with tinnitus and vertigo being prominent symptoms in many cases. Imaging studies revealed sarcoid granulomas affecting multiple cranial nerves, with involvement of the vestibulocochlear nerve and surrounding areas. Specific abnormalities were noted in the cochleovestibular system, and the vestibular system was significantly impacted in some cases. Following treatment with corticosteroids and immunosuppressive agents, significant clinical improvement was observed in hearing loss, tinnitus, and vertigo in many patients, with 57% reporting symptom improvement at the last follow-up.
Conclusion: Neurosarcoidosis can lead to a wide range of cochleovestibular symptoms, and early detection through comprehensive diagnostic approaches is crucial for effective management. This study underscores the importance of considering neurosarcoidosis as a potential cause in patients presenting with unexplained hearing loss, vertigo, or tinnitus, particularly when other neurological signs are also present.