Movement disorders associated with systemic autoimmune diseases: A narrative review

Abstract

Systemic autoimmune diseases (SAIDs) result from immunological disturbances resulting in multisystem involvement, including the nervous system. These disorders include common diseases such as rheumatoid arthritis and systemic lupus erythematosus (SLE) and rare disorders like Behçet’s disease and celiac disease. With the basal ganglia and cerebellum being a common target, movement disorders are reported in several SAIDs. Although the exact pathophysiology is not clear, immune-mediated involvement and inflammatory lesions in the basal ganglia and cerebellum appear to be likely causes for movement disorders in these illnesses. While chorea is the most common movement disorder in SLE and antiphospholipid syndrome, parkinsonism is common in primary Sjögren’s syndrome, and ataxia in neuro-Behçet’s disease and celiac disease. In accordance with the implicated pathophysiology, these disorders often involve immunomodulation, and hence, it is important to suspect and diagnose early.