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QJM Advance Access originally published online on January 24, 2006
QJM 2006 99(2):69-79; doi:10.1093/qjmed/hcl005
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© The Author 2006. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Review

Neurological involvement in patients with rheumatic disease

N. Sofat1, O. Malik2 and C.S. Higgens1

From the 1Department of Rheumatology, Northwick Park Hospital, Middlesex and 2Department of Neurology, Charing Cross Hospital, London, UK

Address correspondence to Dr N. Sofat, Department of Rheumatology, Northwick Park Hospital, Watford Road, Harrow, Middlesex HA1 3UJ, UK. email: n.sofat{at}imperial.ac.uk

Patients with multi-system rheumatic conditions may have disease affecting the central and peripheral nervous systems. Early assessment is often helpful in averting the development of serious complications, which in some conditions can be prevented by the prompt institution of treatment. We review the spectrum of neurological disease in patients with a rheumatological diagnosis. The wide variety of associated neurological complications is discussed in the context of specific rheumatic conditions, varying from spinal cord involvement in rheumatoid arthritis, to neuropsychiatric involvement in systemic lupus erythematosus and neurological sequelae in vasculitic disorders. We discuss diagnostic criteria and recommended management options (where available), and describe the role of new tools such as functional brain imaging in the diagnosis and monitoring of disease. We also discuss the potential for development of neurological complications from the use of anti-rheumatic drugs.


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