Neurological complications of primary Sjogren's syndrome

Objective: To better delineate the spectrum of neurological complications o f primary Sjogren's syndrome (PSS). Methods: A detailed neurological invest igation was prospectively performed in a group of 25 consecutive patients w ith PSS followed in an internal medicine department between June 1996 and D ecember 1997 (Internal Medicine group). In addition, eleven patients with n eurological complications of PSS were identified in the Neurological Depart ment of the same institution during the same period (Neurological group). R esults: In the Internal Medicine group, neurological complications were dis covered in 10/25 (40%) patients. Peripheral nervous system involvement was present in 4/25 patients from the Internal Medicine group and in 10/11 pati ents from the Neurological group and consisted mainly of axonal sensorimoto r/sensory polyneuropathy. A motor neuron syndrome was identified in two pat ients. CNS involvement occurred in 7/25 patients from the Internal Medicine group and in 4/11 patients from the Neurological group. Three patients had spinal cord involvement. Cognitive dysfunction was the most frequent findi ng (5/25 in the Internal Medicine group, 3/11 in the Neurological group) ch aracterized either by subcortical or corticosubcortical dysfunction. Cognit ive impairment was not attributed to mood disturbance and was not associate d with specific laboratory or radiological abnormalities. Conclusion: Neuro logical complications of PSS are frequent since they were present in 40% (1 0/25) of patients in a consecutive series of patients from a department of Internal Medicine. Although PNS involvement predominates, complications of PSS affecting the brain or spinal cord are not rare, with subcortical dysfu nction as the main finding.