title: Atypical neurologic complications in patients with primary Sjögren's syndrome: report of 4 cases.
abstract: BACKGROUND
  Neurologic involvement occurs in approximately 25% of patients with primary Sjögren's syndrome. Manifestations are diverse and can affect the entire neuroaxis. Central nervous system dysfunction involves the brain as well as the spinal cord and may recur over time. Due to a variety of presentations, Sjögren's syndrome with neurologic involvement may be difficult to diagnose.
  
  
  METHODS
  We report 4 cases of patients with primary Sjögren's syndrome who presented with atypical neurologic manifestations.
  
  
  RESULTS
  The first case describes a patient with a pseudotumoral lesion. The second patient was a 54-year-old woman suffering from a multiple mononeuropathy. The third case describes a 66-year-old man whose primary Sjögren's syndrome presented as progressive multiple sclerosis, and the fourth case reports a 57-year-old woman patient suffering from myelitis along with progressive cognitive disorders.
  
  
  CONCLUSIONS
  Neurologic impairment in Sjögren's syndrome is probably underestimated and the diagnosis is often delayed. Primary Sjögren's syndrome should be suspected in patients presenting with atypical clinical and radiologic neurologic manifestations.
authors.affiliation: Service de Neurologie, Centre Hospitalier Universitaire de Nantes, Hôpital Laennec, Nantes Cedex, France. Laure.michel@univ-nantes.fr
authors.forename: Laure
authors.initials: L
authors.lastname: Michel
authors.forename: Frédérique
authors.initials: F
authors.lastname: Toulgoat
authors.forename: Hubert
authors.initials: H
authors.lastname: Desal
authors.forename: David Axel
authors.initials: DA
authors.lastname: Laplaud
authors.forename: Armelle
authors.initials: A
authors.lastname: Magot
authors.forename: Mohamed
authors.initials: M
authors.lastname: Hamidou
authors.forename: Sandrine
authors.initials: S
authors.lastname: Wiertlewski
mesh_terms: D000368:Aged; D001921:Brain / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020422:Mononeuropathies / Q000209:etiology* / Q000473:pathology; D009103:Multiple Sclerosis / Q000209:etiology* / Q000473:pathology; D009187:Myelitis / Q000209:etiology* / Q000473:pathology; D011559:Pseudotumor Cerebri / Q000209:etiology* / Q000473:pathology; D012859:Sjogren's Syndrome / Q000150:complications* / Q000473:pathology