title: Neurological abnormalities in localized scleroderma of the face and head: a case series study for evaluation of imaging findings and clinical course.
abstract: BACKGROUND
  Localized scleroderma (LoS) of the face and head is often associated with neurological manifestations and/or imaging abnormalities in the central nervous system (CNS).
  
  
  METHODS
  We present an analysis of 20 cases of LoS affecting the face and head. The CNS symptoms and/or abnormalities in high-resolution computed tomography (HRCT) and/or magnetic resonance imaging (MRI) were observed in 12 patients (60%). In addition to the mild and unspecific disorders (e.g. headaches), serious neurological complications probably in the course of vasculitis were revealed: epilepsy (in two patients), epilepsy and pyramidal sings (in one patient). Neurological disorders and LoS occurred at the same time (in three patients) or at the course of the disease (nine patients) and no later than 29 years since the onset of the disease. No link between neurological disorders and the LoS clinical morphology, immunological and other laboratory parameters has been established.
  
  
  CONCLUSIONS
  CNS involvement is not correlated with the clinical course of the facial and head LoS and may occur years after the disease initial symptomatology. Imaging follow-up is not required if there is not any emerging neurological symptom. In some cases, however, both HRCT and MRI are useful for monitoring disease evolution and addressing therapeutic choices.
authors.affiliation: a Department of Dermatology, School of Medicine in Katowice , Medical University of Silesia , Katowice , Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Lis-Święty
authors.affiliation: a Department of Dermatology, School of Medicine in Katowice , Medical University of Silesia , Katowice , Poland.
authors.forename: Ligia
authors.initials: L
authors.lastname: Brzezińska-Wcisło
authors.affiliation: a Department of Dermatology, School of Medicine in Katowice , Medical University of Silesia , Katowice , Poland.
authors.forename: Hubert
authors.initials: H
authors.lastname: Arasiewicz
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005145:Face / Q000473:pathology*; D005260:Female; D006257:Head / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009421:Nervous System Malformations / Q000000981:diagnostic imaging / Q000209:etiology*; D012594:Scleroderma, Localized / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: neurological pathology; progressive facial hemiatrophy; scleroderma en coup de sabre