NEUROLOGICAL SYMPTOMS in SJOGREN'S SYNDROME (SS) The involvement of the nerves and nervous system.

Did you know that Neurological Symptoms Strike One in Five Primary Sjogren Patients according to a 2016 study

Neurological symptoms seen in SS include:

Cognitive dysfunction or brain fog causing problems with verbal recall, basic arithmetic and concentration
Chronic inflammatory demyelinating polyradiculoneuropathy CIDP
Cranial neuropathies including trigeminal neuropathy or facial nerve palsy
Dementia
Distal paresthesias (numbness and tingling in fingers and toes)
Encephalopathy
Lower motor neuron disease
Motor and sensory loss
Myelopathy
Neurogenic bladder
Optic neuropathy
Progressive-multiple sclerosis-like syndrome
Seizures
Trigeminal Neuralgia and Glossopharyngeal Neuralgia
Vasculitis

Neurologic complications: A PRIMER ON THE NEUROLOGICAL COMPLICATIONS OF SJÖGREN’S By Julius Birnbaum, MD Johns Hopkins Neurology-Rheumatology Clinic

The neurological complications of Sjogren’s syndrome are extensive and range from cognitive difficulties to burning toes and feet. The nervous system is divided into two anatomic compartments:

The “Central Nervous System” – or CNS – includes the brain and the spinal cord;
The “Peripheral Nervous System” – or PNS – includes larger and smaller nerves, connecting muscles to the spinal cord.

Sjögren’s syndrome can cause inflammation and damage to both the CNS and PNS.

GO TO JOHNS HOPKINSSJÖGREN’S CENTER FOR FULL ARTICLE

Prevalence of neurological manifestations in primary Sjogren's syndrome (PSS) varies widely from 10 to 60%, with pure or predominantly sensory polyneuropathies as the most common neurologic manifestation (e.g. sensory ataxic or small fiber sensory painful neuropathy).

Mononeuropathy multiplex, polyradiculopathy, symptomatic dysautonomia, cranial neuropathy, myopathy, and central nervous system involvement are less common. PUBMED ARTICLE

Neurological involvement in Sjögren syndrome

Dr. Tilman Hottenrott Doctor, University Hospital Freiburg, Department of Neurology and Neurophysiology. Talk on Saturday, March 17, 2018 in Freiburg, Germany.

The good news in advance: Nervous system involvement is only in 10-20% of those affected with Sjogren's. In this case, the peripheral nerves are affected more frequently than the central nervous system.

The symptoms are often already noticeable before the diagnosis is made and can be expressed by pain in the feet, arms and hands, tingling and numbness, ants running and burning of the skin. The regulation of blood pressure when getting up and standing for a long time may get worse. The pupils of the eyes may contract more than is normal. Gait insecurity and discomfort are other symptoms

.
Only 1-5% of patients complain of central nervous system symptoms. These can manifest themselves in cognitive disorders, epileptic seizures and inflammation of the muscles or spinal cord.
These symptoms need to be clarified and differentiated from other conditions that can cause these symptoms as well.

Articles on Neurological Symptoms

Neurological Involvement in Primary Sjögren Syndrome: A Focus on Central Nervous System
Brain fog: Is it Sjogren's Syndrome? at Sjogren's World from a talk titled “Brain Fog and Other Central Nervous System Symptoms: Is it Sjögren’s?” by Susan McDermott, M.D

Neurological Disorders in Primary Sjögren's Syndrome Gabriel J. Tobón, Jacques-Olivier Pers, Valérie Devauchelle-Pensec, and Pierre Youinou

Neurological manifestations of primary Sjögren’s syndrome 2018. Perzyńska-Mazan, Maślińska and Gasik.

Epidemiology of neurological manifestations in Sjögren's syndrome: data from the French ASSESS Cohort. Conclusions: Prevalences of peripheral and central neurological manifestations in pSS are about 15% and 5%, respectively. Neurological manifestations are associated with greater pSS activity.

Peripheral neuropathies associated with primary Sjögren syndrome: immunologic profiles of non ataxic sensory neuropathy and sensorimotor neuropathy.

Efficacy of rituximab in primary Sjögren's syndrome with peripheral nervous system involvement: results from the AIR registry. Conclusion RTX seems effective in cryoglobulinaemia or vasculitis-related PNS involvement in pSS.

Acute motor axonal neuropathy in association with Sjögren syndrome

medical centers that treat sjogren's syndrome

MUSCLES from

Neurological Manifestations Of Sjögren's Syndrome

Steven Mandel, M.D.
Clinical Professor of Neurology
Jefferson Medical College

Myopathy is defined as injury to muscle and myalgia as pain in muscle.

Individuals with muscle problems may have pain on palpation or spontaneous pain (myalgias). They may be unable to climb stairs or carry things (weakness). Individuals may or may not have symptoms.

Individuals may have fever, fatigue, arthralgias, myalgias, or lymphadenopathy. Weakness is more prominent proximally than distally. The course is generally mild and insidious.

Weakness can occur in those with renal involvement, renal tubular acidosis, and hypokalemia. Muscle biopsy may show myositis, but positive biopsy can be found in the absence of clinical symptoms in 17-74% of patients.

When Sjogren's syndrome is suspected in muscle, a sed rate and electromyography should be performed, and muscle and nerve biopsy should be considered. Muscle involvement has been reported to include myositis, muscle fiber necrosis, and elevated muscle enzymes.

TREATMENT OF SJOGREN'S