Peripheral neuropathy in scleroderma

Abstract

Because patients with scleroderma report neuropathic symptoms including numbness, paresthesias, and dysesthesias, we assessed peripheral nerve function in such patients. Fourteen scleroderma patients underwent complete neurologic examination, nerve conduction studies (NCS) and quantitative sensory testing (QST). Neurologic examination revealed reduced vibration (7) or pinprick (4) sensation in the upper or lower extremities, focal atrophy or proximal weakness (2), and decreased deep tendon reflexes (2). NCS showed reduced sensory nerve action potentials (1) and carpal tunnel syndrome (1). QST of the upper and lower extremity revealed increased cold or vibration detection thresholds in 8 of 14 patients. Our findings suggest that peripheral neuropathy occurs in patients with scleroderma at a higher frequency than previously appreciated. These findings cannot be ascribed to compression neuropathies, but rather involve large and small fibers in a non-length-dependent fashion. Larger, prospective studies using the more sensitive QST as well as pathologic studies of nerve, including cutaneous innervation, are needed to further assess the characteristics and etiology of the neuropathy.

High-resolution ultrasound of peripheral nerves in systemic sclerosis: a pilot study of computer-aided quantitative assessment of nerve density

“…Our study suggests that a non-invasive, comprehensive, repeatable, easy and cheap evaluation of peripheral nerves is possible in patients with SSc. The hypothesis that nerve density alteration is vascular based is supported by studies on the small nerve fibres of the skin [25][26][27][28]. Also, the axonal degeneration observed was reverted by factors improving tissue oxygenation [28].…”

Prevalence and Characteristics of Immunomediated Neuropathies in a Group of Patients With Autoimmune Diseases

“…1,20,21 Even though it was considered one of the connective tissue disorders with the least neurological compromise, recent studies suggest that NPs are more frequent than expected. 22,23 As can be observed, the NP prevalence in autoimmune diseases is variable and is more widely studied in the SLE and PSS, because there is a lack of information on the rest of the connective tissue disorders. This can be explained by the lack of controlled studies (information based on case reporting or small series) and methodological differences.…”

Evaluation of dry eye signs and symptoms in patients with systemic sclerosis

“…Future studies should be carried out to evaluate corneal sensation in SSc. Given the fact that SSc is associated with peripheral neuropathy [36,37], decreased corneal sensation may be a manifestation of the systemic disease itself, regardless of the severity of dry eye.…”