Types of Peripheral Neuropathy - Inflammatory

Idiopathic | Pre-diabetic/Diabetic | Hereditary | Toxic/Secondary to Drugs | Inflammatory | Systemic/Metabolic |
Compression | Other Types of PN

It is estimated that one to four million people in America suffer from Sjögren's syndrome, an autoimmune disease in which the body attacks its own healthy moisture-producing glands. The disease typically affects people in their 40s, and 90% of the patients are women. Its hallmark symptoms are dry eyes and a dry mouth, which are caused by a reduction in the production of tears and saliva, respectively. Some patients with Sjögren's may develop peripheral neuropathy.

Sjögren's is often called a rheumatic disease, which means it is characterized by inflammation in joints, muscles, skin, or other body tissue. Sjögren's is also considered a disorder of connective tissue, which is the framework of the body that supports organs and tissues (joints, muscles and skin). People with Sjögren's may have features of rheumatoid arthritis, systemic lupus erythematosus, and vasculitis.

Sjögren's progresses slowly and is often difficult to diagnose because the symptoms are similar to other diseases. The characteristic dryness may be hard to accurately detect because dryness is often a side effect of various medications used to treat other medical conditions. Researchers think Sjögren's is caused by a combination of genetic and environmental factors. The onset of the disease may be triggered by a viral or bacterial infection.

Without proper treatment, Sjögren's may cause significant damage to important organs such as the kidneys, liver and lungs. People with unexplained dryness in their mouth or eyes that lasts for several months should discuss their symptoms with a doctor.

SYMPTOMS AND SIGNS

(Not all symptoms and signs may be present.)

• Dry eyes
• Dry mouth
• Bruising
• Dental cavities and mouth infections
• Difficulty swallowing or chewing
• Enlarged parotid glands (glands behind the jaw, in front of the ears)
• Fatigue
• Inflammation of lungs, kidneys or liver
• Joint pain
• Low-grade fever
• Nosebleeds
• Oral yeast infections
• Skin rashes or dry skin
• Vision problems

EVALUATION AND TESTS

(Not all evaluation and tests may be necessary.)

For peripheral neuropathy:

• Neurological exam
• Electromyography
• Nerve conduction velocity test

For Sjögren's syndrome:

• Blood tests:
  • ANA (anti-nuclear antibody)
  • Anti-SSA and SSB antibodies (tests for antibodies that are often present in people with Sjögren's)
  • RF antibody (rheumatoid factor)
  • Erythrocyte sedimentation rate
  • Immunoglobulin electrophoresis
• Lip biopsy or biopsy of minor salivary glands(tests for evidence of inflammation)
• Urine test (to test for kidney damage)
• Additional tests relating to the mouth and eyes (e.g., Schirmer's test to determine whether eyes are excessively dry)

TREATMENT AND THERAPY

(Not all treatments and therapies may be indicated.)

• Self-care to relieve symptoms
• Artificial tears
• Eye drops
• Body creams / moisturizers
• Drink more fluids
• Increase humidity
• Stop smoking and avoid exposure to second-hand smoke
• Pain medication
• Medication to reduce inflammation
  • Cevimeline (Evoxac®)
  • Corticosteroids
  • Hydroxychloroquine (Plaquenil®, Quineprox®)
  • Nonsteroidal anti-inflammation drugs (NSAIDs)
  • Pilocarpine (Salagen®)