Chronic Inflammatory Meningoencephalitis Should Not Be Mistaken for Alzheimer's Disease

Neurological complications of primary Sjögren's syndrome

“…In agreement with previous reports, cognitive impairment was not correlated with CSF or brain MRI changes which were normal or showed unspecific abnormalities [1,11,13,28,42]. Although severe cognitive dysfunction presenting either as subcortical dementia [13,28] or mimicking Alzheimer's disease [11,42] have been reported in PSS in a few cases, literature data on cognitive dysfunction are scarce [8,35,39,42]. Mild attention/concentration deficits and impaired frontal executive functions have been occasionally reported [8,35,42] but it was not clear whether cognitive impairment could be attributed to mood disturbance or to CNS dysfunction.…”

“…In these two patients, cognitive impairment was associated with overt signs of CNS involvement: tetrapyramidal and pseudobulbar syndrome in both and cerebellar syndrome in one. In agreement with previous reports, cognitive impairment was not correlated with CSF or brain MRI changes which were normal or showed unspecific abnormalities [1,11,13,28,42]. Although severe cognitive dysfunction presenting either as subcortical dementia [13,28] or mimicking Alzheimer's disease [11,42] have been reported in PSS in a few cases, literature data on cognitive dysfunction are scarce [8,35,39,42].…”

Prevalence of Sjögren's syndrome with dementia in a memory clinic

“…Approximately 20% of the patients with SS have central nervous system (CNS) involvement. CNS involvement in SS (CNS SS) presents with transverse myelitis [3] and aseptic meningitis [4], as well as steroid-responsive treatable dementia by means of either angiitis of the brain parenchyma [5][6][7] or nonvasculitic autoimmune inflammatory meningoencephalitis (NAIM) [8,9].…”

Hashimoto’s Thyroiditis and Encephalopathy

“…In support of an antibody-mediated autoimmune mechanism in Hashimoto's encephalopathy, it is notable that patients with meningoencephalitis and corticosteroid-responsive encephalopathy [119] [120] may present with circulating antithyroid antibodies, rheumatoid factor, antinuclear antibody, Sjogren's serology, and cardiolipin antibodies like those with AITD and Hashimoto's ence-phalopathy [44]. In five such patients [120], one had high serum anti-thyroid antibody levels compatible with Hashimoto's encephalopathy (anti-thyroid levels were not mentioned in the other four) and brain tissue biopsy revealed perivascular lymphocytic infiltrates without vessel wall invasion similar to the case described by Rowland and colleagues [61].…”