Skip to main content
Top
Published in: Clinical Rheumatology 2/2017

01-02-2017 | Case Based Review

Neuromyotonia as an unusual neurological complication of primary Sjögren’s syndrome: case report and literature review

Author: Fei Xiao

Published in: Clinical Rheumatology | Issue 2/2017

Login to get access

Abstract

Primary Sjögren’s syndrome (PSS) is a systemic autoimmune disorder characterized by chronic inflammation of exocrine glands such as the lachrymal and salivary glands, leading to xerophthalmia and xerostomia. Neurological manifestations are sometimes found in patients with PSS. A variety of neurological complications has been reported in patients with PSS, and both the central nervous system (CNS) and peripheral nervous system (PNS) can be involved in PSS. Several forms of neuropathy, including polyneuropathy, cranial neuropathy, and multiple mononeuropathy, are often seen in PSS patients. Herein, we report for the first time typical neuromyotonia (NMT) symptoms appearing in a patient with PSS. Neuromyotonia is a rare disorder caused by the hyperexcitability of peripheral nerves, causing spontaneous and continuous muscle contraction. We provide an overview of the literature relating to neurological involvement in PSS, and the etiology of acquired NMT. We also discuss the existence of contactin-associated protein-like 2 (Caspr2) antibodies in NMT patients.
Literature
1.
go back to reference Mori K, Iijima M, Koike H et al (2005) The wide spectrum of clinical manifestations in Sjögren’s syndrome-associated neuropathy. Brain 128(Pt 11):2518–2534CrossRefPubMed Mori K, Iijima M, Koike H et al (2005) The wide spectrum of clinical manifestations in Sjögren’s syndrome-associated neuropathy. Brain 128(Pt 11):2518–2534CrossRefPubMed
2.
go back to reference Delalande S, de Seze J, Fauchais AL et al (2004) Neurologic manifestations in primary Sjögren syndrome: a study of 82 patients. Medicine (Baltimore) 83:280–291CrossRef Delalande S, de Seze J, Fauchais AL et al (2004) Neurologic manifestations in primary Sjögren syndrome: a study of 82 patients. Medicine (Baltimore) 83:280–291CrossRef
3.
go back to reference Mellgren SI, Göransson LG, Omdal R (2007) Primary Sjögren’s syndrome associated neuropathy. Can J Neurol Sci 34(3):280–287CrossRefPubMed Mellgren SI, Göransson LG, Omdal R (2007) Primary Sjögren’s syndrome associated neuropathy. Can J Neurol Sci 34(3):280–287CrossRefPubMed
4.
go back to reference Gono T, Kawaguchi Y, Katsumata Y et al (2011) Clinical manifestations of neurological involvement in primary Sjögren’s syndrome. Clin Rheumatol 30(4):485–490CrossRefPubMed Gono T, Kawaguchi Y, Katsumata Y et al (2011) Clinical manifestations of neurological involvement in primary Sjögren’s syndrome. Clin Rheumatol 30(4):485–490CrossRefPubMed
5.
go back to reference Chai J, Logigian EL (2010) Neurological manifestations of primary Sjogren’s syndrome. Curr Opin Neurol 23(5):509–513CrossRefPubMed Chai J, Logigian EL (2010) Neurological manifestations of primary Sjogren’s syndrome. Curr Opin Neurol 23(5):509–513CrossRefPubMed
6.
go back to reference Griffin J, Cornblath D, Alexander E et al (1990) Ataxic sensory neuropathy and dorsal root ganglionitis associated with Sjögren’s syndrome. Ann Neurol 27(3):304–315CrossRefPubMed Griffin J, Cornblath D, Alexander E et al (1990) Ataxic sensory neuropathy and dorsal root ganglionitis associated with Sjögren’s syndrome. Ann Neurol 27(3):304–315CrossRefPubMed
7.
go back to reference Alexander E, Ranzenbach M, Kumar A et al (1994) Anti-Ro (SS-A) autoantibodies in central nervous system disease associated with Sjögren’s syndrome (CNS-SS): clinical, neuroimaging, and angiographic correlates. Neurology 44(5):899–908CrossRefPubMed Alexander E, Ranzenbach M, Kumar A et al (1994) Anti-Ro (SS-A) autoantibodies in central nervous system disease associated with Sjögren’s syndrome (CNS-SS): clinical, neuroimaging, and angiographic correlates. Neurology 44(5):899–908CrossRefPubMed
8.
go back to reference Mellgren S, Conn D, Stevens J, Dyck P (1989) Peripheral neuropathy in primary Sjögren’s syndrome. Neurology 39(3):390–394CrossRefPubMed Mellgren S, Conn D, Stevens J, Dyck P (1989) Peripheral neuropathy in primary Sjögren’s syndrome. Neurology 39(3):390–394CrossRefPubMed
9.
go back to reference Lecky B, Hughes R, Murray N (1987) Trigeminal sensory neuropathy. A study of 22 cases. Brain 110(Pt 6):1463–1485CrossRefPubMed Lecky B, Hughes R, Murray N (1987) Trigeminal sensory neuropathy. A study of 22 cases. Brain 110(Pt 6):1463–1485CrossRefPubMed
10.
go back to reference Satake M, Yoshimura T, Iwaki T, Yamada T, Kobayashi T (1995) Anti-dorsal root ganglion neuron antibody in a case of dorsal root ganglionitis associated with Sjögren’s syndrome. J Neurol Sci 132(2):122–125CrossRefPubMed Satake M, Yoshimura T, Iwaki T, Yamada T, Kobayashi T (1995) Anti-dorsal root ganglion neuron antibody in a case of dorsal root ganglionitis associated with Sjögren’s syndrome. J Neurol Sci 132(2):122–125CrossRefPubMed
13.
go back to reference Deymeer F, Oge AE, Serdaroglu P, Yazici J, Ozdemir C, Baslo A (1998) The use of botulinum toxin in localizing neuromyotonia to the terminal branches of the peripheral nerve. Muscle Nerve 21:643–646CrossRefPubMed Deymeer F, Oge AE, Serdaroglu P, Yazici J, Ozdemir C, Baslo A (1998) The use of botulinum toxin in localizing neuromyotonia to the terminal branches of the peripheral nerve. Muscle Nerve 21:643–646CrossRefPubMed
14.
15.
go back to reference Garcia-Merino A, Cabello A, Mora JS, Liaño H (1991) Continuous muscle fiber activity, peripheral neuropathy, and thymoma [see comments]. Ann Neurol 29:215–218 Comment in: Ann Neurol 1991;30:735–6CrossRefPubMed Garcia-Merino A, Cabello A, Mora JS, Liaño H (1991) Continuous muscle fiber activity, peripheral neuropathy, and thymoma [see comments]. Ann Neurol 29:215–218 Comment in: Ann Neurol 1991;30:735–6CrossRefPubMed
16.
go back to reference Sigwald J, Raverdy P, Fardeau M et al (1966) Rev Neurol (Paris) 115:1003–1014 Sigwald J, Raverdy P, Fardeau M et al (1966) Rev Neurol (Paris) 115:1003–1014
17.
go back to reference Martinelli P, Patuelli A, Minardi C, Cau A, Riviera AM, Dal Pozzo F (1996) Neuromyotonia, peripheral neuropathy and myasthenia gravis. Muscle Nerve 19:505–510CrossRefPubMed Martinelli P, Patuelli A, Minardi C, Cau A, Riviera AM, Dal Pozzo F (1996) Neuromyotonia, peripheral neuropathy and myasthenia gravis. Muscle Nerve 19:505–510CrossRefPubMed
18.
go back to reference Hart IK, Maddison P, Newsom-Davis J, Vincent A, Mills KR (2002) Phenotypic variants of autoimmune peripheral nerve hyperexcitability. Brain 125:1887–1895CrossRefPubMed Hart IK, Maddison P, Newsom-Davis J, Vincent A, Mills KR (2002) Phenotypic variants of autoimmune peripheral nerve hyperexcitability. Brain 125:1887–1895CrossRefPubMed
19.
go back to reference Irani SR, Vincent A (2016) Voltage-gated potassium channel-complex autoimmunity and associated clinical syndromes. Handb Clin Neurol 133:185–197CrossRefPubMed Irani SR, Vincent A (2016) Voltage-gated potassium channel-complex autoimmunity and associated clinical syndromes. Handb Clin Neurol 133:185–197CrossRefPubMed
20.
go back to reference Irani SR, Alexander S, Waters P et al (2010) Antibodies to Kv1 potassium channel-complex proteins leucine-rich, glioma inactivated 1 protein and contactin-associated protein-2 in limbic encephalitis, Morvan’s syndrome and acquired neuromyotonia. Brain 133(9):2734–2748CrossRefPubMedPubMedCentral Irani SR, Alexander S, Waters P et al (2010) Antibodies to Kv1 potassium channel-complex proteins leucine-rich, glioma inactivated 1 protein and contactin-associated protein-2 in limbic encephalitis, Morvan’s syndrome and acquired neuromyotonia. Brain 133(9):2734–2748CrossRefPubMedPubMedCentral
21.
22.
go back to reference van Sonderen A, Ariño H, Petit-Pedrol M et al (2016) The clinical spectrum of Caspr2 antibody-associated disease. Neurology 87(5):521–528CrossRefPubMed van Sonderen A, Ariño H, Petit-Pedrol M et al (2016) The clinical spectrum of Caspr2 antibody-associated disease. Neurology 87(5):521–528CrossRefPubMed
Metadata
Title
Neuromyotonia as an unusual neurological complication of primary Sjögren’s syndrome: case report and literature review
Author
Fei Xiao
Publication date
01-02-2017
Publisher
Springer London
Published in
Clinical Rheumatology / Issue 2/2017
Print ISSN: 0770-3198
Electronic ISSN: 1434-9949
DOI
https://doi.org/10.1007/s10067-016-3499-z

Other articles of this Issue 2/2017

Clinical Rheumatology 2/2017 Go to the issue
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.