{"id":152294,"date":"2024-03-05T14:35:31","date_gmt":"2024-03-05T19:35:31","guid":{"rendered":"https:\/\/effectsofanxiety.net\/archives\/152294"},"modified":"2024-03-05T14:35:31","modified_gmt":"2024-03-05T19:35:31","slug":"how-to-diagnose-sjogrens-syndrome-affecting-the-brain-and-spine","status":"publish","type":"post","link":"https:\/\/effectsofanxiety.net\/archives\/152294","title":{"rendered":"How to diagnose Sjogren’s Syndrome affecting the brain and spine?"},"content":{"rendered":"
https:\/\/www.youtube.com\/watch?v=St2ftqhZN3s<\/div>How do we diagnose Neurosjogren or Sjogren\u00a0 involving the central nervous system?\u00a0 Cerebrospinal fluid or the spinal\u00a0 fluid analysis is very important\u00a0\u00a0 for the diagnosis of Neurosjogren. We can see certain changes like your\u00a0\u00a000:00:18<\/a>lymphocytes being elevated there your IGG index\u00a0 being elevated but less oligoclonal bands and\u00a0\u00a0 we’ll talk about that in a little bit. We also do blood work the blood work\u00a0\u00a0 that I mentioned before we test\u00a0 for your Ana SSA and SSB antibody.\u00a000:00:38<\/a>We look at your number of white blood cells we\u00a0 look to see if you have more gamma globulins.\u00a0 We look to see if you have chromative Factor\u00a0 complement levels all of these are important to\u00a0\u00a0 be tested and what it was seen in patients that\u00a0 have CNS involvement or central nervous system\u00a0\u00a000:01:01<\/a>involvement is that not all of them they have a\u00a0 positive n a and only 38 will have a positive DNA\u00a0\u00a0 about 48 percent have a positive SSA and only\u00a0 six percent will have a positive SSB antibody\u00a0\u00a0 as I just mentioned in shogron that affects your\u00a0 brain and your spine only 40 to 50 percent of them\u00a0\u00a000:01:28<\/a>will have a positive SSA antibody and only six\u00a0 percent will have a positive SSB antibody and this\u00a0\u00a0 is important because that makes the diagnosis very\u00a0 challenging this type of antibodies SSA antibodies\u00a0\u00a0 they actually have been associated with a more\u00a0 aggressive disease of the brain what does it\u00a0\u00a000:01:52<\/a>mean it means that if you have SSA antibodies\u00a0 with neurological involvement that could mean\u00a0\u00a0 that you have a more aggressive disease towards\u00a0 your brain or your spine we do use other tests\u00a0\u00a0 like visual evoked potential which are abnormal\u00a0 in 61 percent of patients we use EEG or Electro\u00a0\u00a000:02:15<\/a>asphalogram which sometimes has a limited value\u00a0 but it can be useful to detect subclinical signs\u00a0\u00a0 of neurological involvement we also use MRI and\u00a0 I’m going to take the time to explain to you\u00a0\u00a0 the value of MRI in neurological involvement\u00a0 of shogran MRIs are more sensitive that CAT\u00a0\u00a000:02:37<\/a>scans to detect anatomical abnormalities in\u00a0 primary CNS or primary neurological chogran\u00a0\u00a0 there are multiple areas of increased signal\u00a0 that will show inflammation specifically\u00a0\u00a0 located in the subcortical and periventricular\u00a0 white matter and those lesions are found more\u00a0\u00a000:03:02<\/a>frequently in patients that have involvement\u00a0 of their brain let me talk to you more about\u00a0\u00a0 brain MRI findings in sjogren I mentioned to you\u00a0 about white matter lesions and I made the comment\u00a0\u00a0 that they have to be located in certain areas\u00a0 like periventricular areas and this makes the\u00a0\u00a000:03:23<\/a>diagnosis challenging because some patients with\u00a0 multiple sclerosis they can have the lesions in\u00a0\u00a0 the same areas we’ll talk more about that in\u00a0 a little bit in some patients we do see signs\u00a0\u00a0 of cerebral Venous Thrombosis and in other\u00a0 patients we do see two more like lesions that\u00a0\u00a000:03:42<\/a>are actually not tumor but there is a sign of\u00a0 program syndrome let’s talk about spinal MRIS\u00a0\u00a0 spinal MRIs are ordered to evaluate the spinal\u00a0 cord involvement and they can show in patients\u00a0\u00a0 with sjogren intensities or hyperintensities in\u00a0 the cervical area most of the time 82 percent\u00a0\u00a000:04:07<\/a>of patients will have that problem or they\u00a0 can have extended lesions in cases of acute\u00a0\u00a0 myelopathy this is an MRI of a patient with\u00a0 Hyper signal in the cord that is suggestive\u00a0\u00a0 of acute myelopathy this is also an MRI from a\u00a0 patient with extensive transverse myelitis this is\u00a0\u00a000:04:35<\/a>also another MRI of a patient with neuromyelitis\u00a0 Optica a patient that also has shogron this is\u00a0\u00a0 another case of neuromyelitis optica where you\u00a0 can see involvement of the dorsal midbrain and\u00a0\u00a0 and the point in lesion in a patient with sjogren\u00a0 that develop neuromyelitis Optica we also use\u00a0\u00a000:04:59<\/a>combinations of tests like MRI and a voxel-based\u00a0 morphometry and this is a method commonly used\u00a0\u00a0 to quantitate and objectively evaluate the\u00a0 differences in Regional cerebral volumes this\u00a0\u00a0 type of test was able to shown that patients with\u00a0 sjogren had certain areas of white matter hyper\u00a0\u00a000:05:22<\/a>intensities and those areas were also associated\u00a0 with more atrophy these studies show that Patients\u00a0\u00a0 with Primary sjogren that have this white matter\u00a0 intensities and gray and white matter atrophy\u00a0\u00a0 those are probably related to a sort of cerebral\u00a0 vasculitis or inflammation in the vessels of the\u00a0\u00a000:05:46<\/a>brain there are other tests like single Photon\u00a0 emission CT fees or pet scans that can evaluate\u00a0\u00a0 the blood flow in the brain and it was shown\u00a0 that patients with children they have reduced\u00a0\u00a0 cerebral blood flow they have brain atrophy and\u00a0 decreased glucose metabolism in the brain in\u00a0\u00a000:06:08<\/a>certain patients neuropsychological testing it’s\u00a0 also very important to evaluate symptoms that are\u00a0\u00a0 very subtle in affecting the brain cerebral\u00a0 angiography is used more rarely in patients\u00a0\u00a0 with primary sjogren but when it was used in 45\u00a0 percent of Highly selected patients with children\u00a0\u00a0
Source : Youtube<\/a><\/div><\/div>","protected":false},"excerpt":{"rendered":"

https:\/\/www.youtube.com\/watch?v=St2ftqhZN3sHow do we diagnose Neurosjogren or Sjogren\u00a0 involving the central nervous system?\u00a0 Cerebrospinal fluid or the spinal\u00a0 fluid analysis is very important\u00a0\u00a0 for the diagnosis of Neurosjogren. We can see certain changes like your\u00a0\u00a000:00:18lymphocytes being elevated there your IGG index\u00a0 being elevated but less oligoclonal bands and\u00a0\u00a0 we’ll talk about that in a little bit. … Continue reading How to diagnose Sjogren’s Syndrome affecting the brain and spine?<\/span><\/a><\/p>\n","protected":false},"author":3,"featured_media":152295,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","enabled":false},"version":2}},"categories":[1973],"tags":[],"class_list":["post-152294","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-legislative-branch"],"jetpack_publicize_connections":[],"jetpack_sharing_enabled":true,"jetpack_featured_media_url":"https:\/\/effectsofanxiety.net\/wp-content\/uploads\/2024\/03\/1709667331-maxresdefault.jpg","_links":{"self":[{"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/posts\/152294"}],"collection":[{"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/comments?post=152294"}],"version-history":[{"count":0,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/posts\/152294\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/media\/152295"}],"wp:attachment":[{"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/media?parent=152294"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/categories?post=152294"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/tags?post=152294"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}