Neurologic Manifestations in Collagen Diseases

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Abstract
Neurologic manifestations of certain collagen diseases[long dash]systemic lupus erythematosus, periarteritis nodosa, dermatomyositis, and scleroderma[long dash]were reviewed with particular emphasis upon prognosis and therapy. Methods and results of acute and long-term treatment, especially with the hormones cortisone and ACTH, were presented both in relation to the general disorder and the neurologic manifestations. Problems concerning occurrence of complications such as seizures, abnormal mental states, and asthenia were reviewed with regard to mechanisms, diagnosis, and considerations concerning continued therapy. It was emphasized that present concepts of these diseases include a natural history in each which may be extremely variable, with spontaneous exacerbations and remissions often lasting long periods of time. These factors make evaluation of therapy extremely difficult. The most effective treatments available at present are the hormones cortisone and ACTH, but these treatments are only suppressive in nature and not biologically curative. These hormones induce profound metabolic and systemic changes of the hyperadrenal state of Cushing''s syndrome and must be given with great care.[long dash].