Beyond the joints Neurological involvement in rheumatoid arthritis

• Published in: Clinical rheumatology Vol. 31; no. 1; pp. 1 - 12
• Main Authors: Ramos-Remus, Cesar, Duran-Barragan, Sergio, Castillo-Ortiz, Jose Dionisio
• Format: Journal Article
• Language: English
• Published: London Springer-Verlag 2012; Springer Nature B.V
• Subjects: Antirheumatic Agents - adverse effects; Arthritis, Rheumatoid - diagnosis; Arthritis, Rheumatoid - drug therapy; Arthritis, Rheumatoid - epidemiology; Autonomic Nervous System Diseases - diagnosis; Autonomic Nervous System Diseases - epidemiology; Central Nervous System Diseases - diagnosis; Central Nervous System Diseases - epidemiology; Central Nervous System Diseases - etiology; Comorbidity; Early Diagnosis; Humans; Medicine; Medicine & Public Health; Peripheral Nervous System Diseases - diagnosis; Peripheral Nervous System Diseases - epidemiology; Peripheral Nervous System Diseases - etiology; Review Article; Rheumatology; Compression neuropathies; Dysautonomia; Entrapment neuropathies; Drug toxicity; Rheumatoid arthritis; Noncompressive neuropathies
• ISSN: 0770-3198; 1434-9949
• DOI: 10.1007/s10067-011-1841-z

Although arthritis is the most notable component, rheumatoid arthritis (RA) is a systemic inflammatory disorder where extra-articular manifestations are common; among them, central and peripheral nervous system involvement is frequent and associated with significant morbidity and, in some cases, reduced life span. It may produce a myriad of symptoms and signs ranging from subtle numbness in a hand, to quadriparesis and sudden death. Central and peripheral neurologic manifestations may arise from structural damage produced by RA in diarthroidal joints, by the systemic inflammatory process of the disease itself or by the drugs used to treat it. Neurologic syndromes may appear suddenly or developed slowly through months, and emerge early or after years of having RA. Neurologic manifestations may be easily overlooked or incorrectly assigned to peripheral arthritis unless the attending physician is aware of these complications. In this article, we review neurologic involvement in RA patients with emphasis on clinical approach for early detection.