Journal
RHEUMATIC DISEASE CLINICS OF NORTH AMERICA
Volume 43, Issue 4, Pages 561-+Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.rdc.2017.06.005
Keywords
Rheumatoid arthritis; Atlantoaxial subluxation; Cervical spine subluxation; Rheumatoid meningitis; Rheumatoid vasculitis; Compression neuropathy
Categories
Funding
- Russell Engleman Rheumatology Research Center
- Arthritis Foundation
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Neurologic manifestations of rheumatoid arthritis (RA) range in severity from mild paresthesias in the hand from carpal tunnel syndrome to sudden death caused by impingement of the medulla by an eroded, vertically subluxed dens. Most neurologic complications are a consequence of articular inflammation and damage that leads to compression of adjacent structures of the central or peripheral nervous systems. Rare but serious extra-articular manifestations include inflammation of the meninges and ischemic neuropathies caused by necrotizing arteritis of the vasa vasorum. Medical therapy with synthetic disease-modifying antirheumatic drugs and biologic agents has diminished the incidence of serious neurologic manifestations in RA.
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