Neurological Manifestations of Rheumatic disorders

Abstract Rheumatologic disorders represent a broad spectrum of systemic conditions manifested by multisystem involvement and mediated by autoimmunity and inflammation. Neurologic manifestations of these disorders may occur at any point in the disease process and are diagnostically challenging. For years CNS was considered a system uniquely protected from effects of the immune system because of the blood brain barrier (BBB). Indeed, under physiologic conditions immune access to CNS is tightly regulated. Over the past decade, new scientific discoveries highlighted pathways by which immune and neurologic systems interact, including variety of mechanisms controlling permeability of BBB, specific roles CD4+ and CD8+ T-lymphocytes play in initiation of specific adaptive immune response to neural antigens leading to release of proinflammatory cytokines ( IL-1, IL-6 and TNF-α). In addition B-cells, involved in CNS inflammation produce antibodies against membrane bound and soluble antigens. This review article describes specific neurologic manifestations of most common autoimmune disorders.