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We report two cases of possible neurosarcoidosis in the pediatric age group. Our first patient presented to us with seizures at the age of 13 years, whereas our second patient presented with headaches and vomiting at the age of 10 years. Both patients had elevated cerebrospinal fluid protein levels and leptomeningeal enhancement on magnetic resonance imaging (MRI); however, one patient also had a pituitary lesion. Tests for tuberculosis were negative for both. One of the 2 patients exhibited normal angiotensin-converting enzyme levels at the start of symptoms but later showed raised angiotensin-converting enzyme levels. His diagnosis was delayed as he was treated initially for central nervous system infections. His disease course showed frequent relapses with varying clinical symptoms. After trying steroids and different immunosuppressive agents, he was given a rituximab infusion, and he went into remission. Our cases contribute to the literature for addressing diagnostic and management challenges in children with neurosarcoidosis.<\/jats:p>","DOI":"10.1177\/08830738241304167","type":"journal-article","created":{"date-parts":[[2025,1,13]],"date-time":"2025-01-13T02:49:35Z","timestamp":1736736575000},"page":"305-311","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Unveiling Pediatric Neurosarcoidosis Mimicking Central Nervous System Tuberculosis: Diagnostic Challenges"],"prefix":"10.1177","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7655-6222","authenticated-orcid":false,"given":"Mohammad","family":"Raza","sequence":"first","affiliation":[{"name":"Section of Pediatric Neurology, Department of Pediatrics and Child Health, Aga Khan University Hospital, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4235-1357","authenticated-orcid":false,"given":"Isbaah","family":"Tejani","sequence":"additional","affiliation":[{"name":"Health Data Science Centre, Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shahnaz","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"Section of Pediatric Neurology, Department of Pediatrics and Child Health, Aga Khan University Hospital, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,1,12]]},"reference":[{"key":"e_1_3_3_2_2","article-title":"Fauroux B.","volume":"32","author":"Clement A","year":"2005","unstructured":"Clement A, Epaud R. 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