neurologic symptoms in SS

Q: Neurologic symptoms precede the diagnosis of Sjögren's syndrome (SS)?

A) True

B) False

Answer: A

It is imperative that neurologic symptoms precede the diagnosis of Sjögren's syndrome (SS). Patients may have classic symptoms of SS such as dry eyes, dry mouth, dental caries, or parotid gland enlargement but usually, get missed.

Another hurdle in the diagnosis is the wide array of neurologic manifestations in SS. It may present as brain fog, meningoencephalitis, autoimmune encephalitis, headache, psychiatric disorders, asymptomatic MRI lesions, optic neuritis, transverse myelitis, neuromyelitis optica spectrum disorder (NMOSD), and progressive spastic paraparesis.

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References:

1. McCoy SS, Baer AN. Neurological Complications of Sjögren's Syndrome: Diagnosis and Management. Curr Treatm Opt Rheumatol 2017; 3:275.

2. Margaretten M. Neurologic Manifestations of Primary Sjögren Syndrome. Rheum Dis Clin North Am 2017; 43:519.

3. Bhattacharyya S, Helfgott SM. Neurologic complications of systemic lupus erythematosus, sjögren syndrome, and rheumatoid arthritis. Semin Neurol 2014; 34:425.

4. Alunno A, Carubbi F, Bartoloni E, et al. The kaleidoscope of neurological manifestations in primary Sjögren's syndrome. Clin Exp Rheumatol 2019; 37 Suppl 118:192.