Sjögren’s syndrome consists of neurological symptoms including peripheral neuropathy and myelitis. In nearly 20 percent of Sjögren’s syndrome cases the condition can affect the nervous system. The main symptoms of Sjögren’s syndrome include dry eyes and dry mouth, but neurological symptoms, too, may occur, the three most common being sensory ganglionopathy (also known as sensory neuronopathy or sensory ataxic neuropathy), painful small fibre neuropathy, and transverse myelitis.
Peripheral neuropathy and Sjögren’s syndrome
Peripheral neuropathy refers to damage caused to the peripheral nerves which can lead to weakness and numbness and commonly occurs in the feet or hands. Below are 10 facts about peripheral neuropathy and Sjögren’s syndrome.
Firstly, peripheral neuropathy is a chronic condition meaning it occurs for life. Reducing pain associated with peripheral neuropathy may take a long time, just like its onset.
Peripheral neuropathy in Sjögren’s syndrome may begin in the feet, hands, thighs, hands, arms, torso, and even the face.
There are a variety of treatments when it comes to peripheral neuropathy that are available and so speaking with your doctor can help you pick the best one.
Antidepressants are commonly used to treat peripheral neuropathy but have been found to increase mouth and eye dryness and so they are not commonly used as a first line of treatment in Sjögren’s syndrome patients.
Electrophysiologic tests may be useful in diagnosing neuropathies affecting larger nerves but cannot detect neuropathy in smaller nerves that are not coated in myelin – a nerve insulator.
Biopsy tests can also help diagnose peripheral neuropathy in Sjögren’s syndrome.
Some rare neuropathies can lead to weakness in Sjögren’s syndrome patients and these types can occur suddenly unlike other types which may occur gradually and over time.
Although immunosuppressants may be used to treat some neuropathies there is not enough evidence to support it as a treatment for all.
Frequent pain may raise concern for patients that they are at an increased risk for severe motor weakness but it weakness is not present this most likely will not occur.
Lastly, it is possible to relieve pain but there may be much trial and error when it comes to finding the best form of treatment.
Sjögren’s syndrome and myelitis (inflammation of the spinal cord)
Myelitis is inflammation of the spinal cord. The myelin is an insulator around our nerves which keeps them protected. Myelitis can cause weakness, numbness and difficulty with urination or passing bowel movements. Although myelitis may occur quickly symptoms generally appear gradually and can often be confused with multiple sclerosis.
Appropriate testing can help distinguish between myelitis and multiple sclerosis. Types of diagnostic testing include a spinal tap and MRI of the brain and spinal cord. Proper diagnosis is essential because multiple sclerosis and myelitis in Sjögren’s syndrome require very different modes of treatment. If the two conditions are confused, improper diagnosis can actually lead to flare-ups and worsening of symptoms.
Other types of neuropathy in Sjögren’s syndrome
Aside from the types of neuropathy we already mentioned, there are other types as well which can occur in Sjögren’s syndrome which include:
- Autonomic neuropathy: nerve damage occurs to nerves which regulate heartbeat, respiration and gastric motility.
- Trigeminal neuralgia and glossopharyngeal neuralgia: numbness or burning of the face.
- Mononeuritis multiplex: weakness or clumsiness which may cause weakness or paralysis of different muscles.
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