Neuropsychiatric abnormalities in primary Sjögren's syndrome

Abstract

Neuropsychiatric abnormalities were searched for in 52 patients with primary Sjögren's syndrome (SS). 40 patients were evaluated with a detailed neurologic history and physical examination and determination of terminal latencies and nerve conduction velocities of all limbs. Nineteen of them, plus another 12 primary SS patients were evaluated for hostility structure and psychiatric symptoms, using the Hostility and Direction of Hostility Questionnaire (HDHQ) and the Symptoms Check List-90R (SCL-90R) respectively and the results were compared with those of 33 healthy women and 41 cancer patients. Three patients had face numbness and/or hypesthesia indicating trigeminal involvement. Ten had mild sensory or mixed neuropathy of the glove-stocking type. None of our patients volunteered peripheral nervous system (PNS) symptoms nor did we detect central nervous system (CNS) involvement in any of them. One patient with purpura, glomerulonephritis and cryoglobulinemia presented with severe mononeuritis multiplex. High levels of introverted hostility were reported by SS patients in relation to the other two groups. In addition, higher scores on paranoid ideation, somatization and obsessive compulsiveness were found in SS patients compared to the rest but no correlation was found between psychiatric symptomatology and neurologic abnormalities. It is suggested that PNS disease is relatively common and benign in most primary SS patients, psychiatric disorders, sometimes serious, are also common, but CNS involvement must be rather rare.