• Sjögren’s syndrome
• sensory neuropathy

Sensory neuropathy with prominent ataxia reflecting kinesthetic sensory impairment is a well recognised form of neuropathy associated with Sjögren’s syndrome.^1–4 Pathologically, T cell invasion of dorsal root ganglia, loss of large sensory neurons, and secondary large fibre degeneration is seen in this neuropathy.⁴ However, a form of neuropathy associated with Sjögren’s syndrome, presenting with pain and superficial sensory involvement without sensory ataxia has been described anecdotally⁵ and in a case report.⁶ Clinicopathological details of the second form of neuropathy have not been elucidated. In this report we describe seven patients with Sjögren’s syndrome showing painful sensory neuropathy without sensory ataxia.

Patients studied were referred for painful neuropathy to Nagoya University Hospital and its affiliated institutions. All seven patients fulfilled diagnostic criteria for Sjögren’s syndrome by the American-European Consensus Group⁷ and showed painful peripheral neuropathy (table 1). Patients included six women and one man, ranging from 25 to 72 years old. In all patients initial symptom of neuropathy was paraesthesia or painful dysaesthesia in the most distal portions of the extremities, later extending proximally to involve the entire legs and arms. The trunk became involved in three patients, and the trigeminal nerve was impaired in three patients. Asymmetry in sensory impairment was present in four patients. None of the patients showed sensory ataxia in the initial phase. Most patients retained essentially normal muscle strength, but patient 1 showed slight weakness in distal limb muscles. …