CENTRAL-NERVOUS-SYSTEM DISEASE IN SJOGREN S-SYNDROME

Our prospective study consisted of a general and neurological evaluati on in 48 patients (41 females, 7 males; mean age: 58.2 years) with pri mary Sjogren's syndrome (PSS). We performed serologic studies and cran ial magnetic resonance imaging (MRI). Main extraglandular features wer e arthralgias and non-erosive arthritis (37.5%), Raynaud (21%) and pul monary fibrosis (12.5%). Antinuclear antibodies were positive in 42.5 % and anti-SS-h (Re) in 20%. Migraine (52%), neuropsychiatric disease (29%) and a past history of focal acute neurological deficits (23%), w ere the central nervous system (CNS) manifestations more frequently ob served. Cranial MRI examination detected hyperintense small subcortica l lesions in 51.3% of patients and in 36.6% of age and sex matched con trols (P < 0.001). CNS disease was not serious concerning vital progno sis, but produced significant morbidity in some patients. Late onset a migraine-like,, episodes with prolonged sensoromotor deficits and coe xisting neuropsychiatric disease emerged as a characteristic clinical spectrum in those patients diagnosed in a neurological setting. Crania l MRI was frequently abnormal, but findings were not specific. Neurolo gic manifestations reminiscent of multiple sclerosis were rarely seen.