Continuum (Minneap Minn). 2020 Jun;26(3):591-610. doi: 10.1212/CON.0000000000000856.
This article describes the neurologic manifestations of systemic autoimmune diseases.
Systemic autoimmune diseases can be associated with a wide spectrum of neurologic comorbidities involving the central and peripheral nervous systems. Systemic lupus erythematosus (SLE) can be associated with a number of manifestations predominantly affecting the central nervous system (CNS), whereas peripheral neuropathy is less common. Sjögren syndrome can be associated with peripheral neuropathy in 10% of cases and CNS disease in 2% to 5% of cases. The risk of stroke is increased in SLE, rheumatoid arthritis, temporal arteritis, psoriatic arthritis, and ankylosing spondylitis. Systemic vasculitides present most commonly with mononeuritis multiplex but can also affect the CNS. Cognitive dysfunction is a common symptom among patients with systemic autoimmune diseases, most commonly seen in patients with SLE or Sjögren syndrome.
Neurologic manifestations of systemic autoimmune disease are important to recognize, as they may often be the presenting manifestation leading to diagnosis of the systemic disease or may be associated with increased morbidity, other complications, or mortality. Timely diagnosis and institution of appropriate treatment, often requiring multidisciplinary care, is essential to minimize morbidity and decrease the risk of permanent neurologic deficits.
本文描述了系统性自身免疫性疾病的神经表现。
系统性自身免疫性疾病可伴有广泛的中枢和周围神经系统的神经合并症。系统性红斑狼疮（SLE）可引起多种主要影响中枢神经系统（CNS）的表现，而周围神经病则较少见。干燥综合征在 10%的病例中可引起周围神经病，在 2%至 5%的病例中可引起中枢神经系统疾病。SLE、类风湿关节炎、颞动脉炎、银屑病关节炎和强直性脊柱炎患者中风的风险增加。系统性血管炎最常见的表现为多发性单神经病，但也可影响中枢神经系统。认知功能障碍是系统性自身免疫性疾病患者的常见症状，最常见于 SLE 或干燥综合征患者。
识别系统性自身免疫性疾病的神经表现很重要，因为它们可能经常是导致系统性疾病诊断的首发表现，或者可能与更高的发病率、其他并发症或死亡率相关。及时诊断和适当的治疗，通常需要多学科的护理，对于最大限度地减少发病率和降低永久性神经功能缺陷的风险至关重要。
