The clinical spectrum of the neurological involvement in vasculitides

Rossi, Carlo Maria; Comite, Gabriele Di

doi:10.1016/j.jns.2009.05.017

Cited by 44 publications

(39 citation statements)

References 85 publications

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“…PNS involvement in systemic vasculitides is caused by ischemic occlusion of the vasa nervorum [115]. CNS involvement is more diverse and can be due to frank vasculitis, granuloma formation, or ischemic damage due to occlusion of extracranial vessels [115].…”

Section: Vasculitidesmentioning

confidence: 99%

“…Giant cell arteritis (GCA) is the most common form of primary vasculitis and affects people>50 years of age [115]. Affected arteries include all the branches of the external carotid artery, namely the superficial temporal artery, the occipital artery, the facial and lingual artery, and the intraorbital branches [116].…”

Section: Giant Cell Arteritismentioning

confidence: 99%

“…Headaches and optic disturbances are the most common neurological manifestations. Amaurosis fugax, diplopia, and eye pain (up to 70 % of cases) are mainly caused by anterior ischemic optic neuropathy and, if left untreated, they can lead to permanent visual loss [2,115].…”

Section: Giant Cell Arteritismentioning

confidence: 99%

“…Ischemic myelopathy and cranial nerve involvement are very rare complications [124,125]. Large-vessel strokes can cause high morbidity and mortality [2,3], and they are mainly caused by emboli from extracranial branches, but intracranial thrombosis or haemorrhage can also occur [115].…”

Section: Takayasu Arteritismentioning

confidence: 99%

“…CNS involvement in these disorders is not very common, accounting for not more than 10 % in most studies [115,130].…”

Section: Antineutrophil Cytoplasmic Antibody-positive Vasculitidesmentioning

confidence: 99%

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Immunotherapies for Neurological Manifestations in the Context of Systemic Autoimmunity

et al. 2016

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Neurological involvement is relatively common in the majority of systemic autoimmune diseases and may lead to severe morbidity and mortality, if not promptly treated. Treatment options vary greatly, depending on the underlying systemic pathophysiology and the associated neurological symptoms. Selecting the appropriate therapeutic scheme is further complicated by the lack of definite therapeutic guidelines, the necessity to differentiate primary neurological syndromes from those related to the underlying systemic disease, and to sort out adverse neurological manifestations caused by immunosuppressants or the biological agents used to treat the primary disease. Immunotherapy is a sine qua non for treating most, if not all, neurological conditions presenting in the context of systemic autoimmunity. Specific agents include classical immune modulators such as corticosteroids, cyclophosphamide, intravenous immunoglobulin, and plasma exchange, as well as numerous biological therapies, for example antitumor necrosis factor agents and monoclonal antibodies that target various immune pathways such as B cells, cytokines, and co-stimulatory molecules. However, experience regarding the use of these agents in neurological complications of systemic diseases is mainly empirical or based on small uncontrolled studies and case series. The aim of this review is to present the state-of-the-art therapies applied in various neurological manifestations encountered in the context of systemic autoimmune diseases; evaluate all treatment options on the basis of existing guidelines; and compliment these data with our personal experience derived from a large number of patients.

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Section: Vasculitidesmentioning

confidence: 99%

Section: Giant Cell Arteritismentioning

confidence: 99%

Section: Giant Cell Arteritismentioning

confidence: 99%