Neurosjogren: An unusual presentation with central nervous system involvement

Introduction. - Neurological manifestations in Sjogren's syndrome are variable. The peripheral nervous system is generally involved. We report a rare case of an unusual central neurological manifestation. Case report. - A 54-year-old woman was admitted with headache and tetraparesia. The physical examination revealed a tetrapyramidal syndrome and a bilateral parotidomegaly. The patient's general condition was nevertheless quite good. Brain MRI showed an heterogeneous pontine lesion with multiple nodular formations in the periventricular white matter. Blood tests revealed anti-SSA and anti-SSB antibodies. A labial salivary gland biopsy was grade IV in Chisholm scoring system and Schirmer's test was positive. Conclusion. - A latent Sjogren's syndrome can lead to a wide variety of focal brain MRI abnormalities and should be evoked when the etiology is not clear. (C) 2009 Elsevier Masson SAS. All rights reserved.