Vasculitis and connective tissue disorders-study from Western India-A neurology perspective

Abstract

Vasculitis and connective tissue disorder (CTD) can present to the neurologist with symptoms involving central nervous system(CNS) and peripheral nervous system(PNS) This is a retrospective study in which data of adult patients from last 10 years was collected from neurological practice inpatient and outpatient records with clinical features suggestive of Vasculitis/CTD according to American College of rheumatology criteria. All diagnosis was reviewed with consensus of two neurologists and a rheumatologist. Outcome was analyzed by comparing Modified Oxford Handicap Scale scoring at the time of first visit and the last follow up visit. Infectious vasculitis, entrapment neuropathy and inflammatory myopathies without vasculitis were excluded. Aim of the present study was to study the spectrum of neurological manifestations and outcome in CTD/vasculitis. 49 patients was enrolled in this study with 18(36.73%) males and 31(63.27%) females. Mean age of onset of the disease was 44.84 years and age of onset of neurological manifestations was 46.65 years (18 yrs–71 yrs). Sjogren syndrome was seen as the most common diagnosis. CNS manifestations were found more commonly than PNS. Mononeuritis multiplex was commonest form of PNS manifestation. Dorsal cord involvement with long segment myelitis was commonly seen. Most patients had increase in acute phase reactants and improved outcome on treatment. 32 patients had follow-up of more than 6 months (up to 10 years). Follow up was limited in some patients. Due to waxing and waning course of the disease we may not have recorded the best clinical outcome.