To study the clinical profile of neurological manifestations in patients with rheumatological diseases.

Neurological involvement in patients with connective tissue diseases is associated with significant morbidity. Involvement of the nervous system may be a striking early or presenting feature with a wide variety of manifestations.

This was a cross sectional and observational study carried out at Sri Ramachandra Medical Centre for a period of one year. All patients attending the outpatient department who were already diagnosed to have a rheumatological disease with neurological manifestations and patients who were admitted with neurological manifestations and were later diagnosed to have a rheumatological disease were taken up for the study. Symptoms pertaining to the central or peripheral nervous system involvement like headache, seizures, altered sensorium, cranial neuropathy, motor and sensory disturbances, involuntary movements, etc were obtained in detail from the patient. A detailed neurological examination was performed in all patients. At least one imaging modality of computed tomography or magnetic resonance imaging of the brain was done on all patients. Nerve conduction studies and Electroencephalogram were done on patients when required.

Among 64 participants in the study, 46 (71.88%) were females. Among the rheumatological conditions, 21 (32.81%) had systemic lupus erythematosus, 13 (20.31%) had Anti-Phospholipid antibody syndrome, 10 (15.63%) had rheumatoid arthritis, 5(7.81%) had vasculitis, 5(7.1%) had sarcoidosis. 21 participants (32.81%) presented with stroke-like manifestations, 21 (32.81%) had headache, 16 (25%) presented with seizures. The most common imaging finding was an arterial infarction which occurred in 15 (23.44%) participants followed by cerebral sinus venous thrombosis which occurred in 12 participants (18.75%).

43.75% of patients with rheumatological diseases had neurological manifestations as their primary presentation of the disease. Of the connective tissue disorders, SLE was most commonly associated with neurological manifestations. Stroke and headache were the two most common neurological manifestations of rheumatological diseases.