[Central nervous system vasculitis and of the peripheral nerves in the elderly]

Ann Med Interne (Paris). 2002 Nov;153(7):450-8.
[Article in French]

Abstract

Vasculitis of the nervous system are rare in the elderly. When present, they may constitute an urgent diagnosis and a therapeutic emergency. Clinical expression is rich and without specificity. Atypical signs (unusual course of dementia, systemic signs) or atypical laboratory results (inflammatory syndrome) may suggest the diagnosis of vasculitis. However, as multiple comorbidity is the rule in elderly subjects, searching for intercurrent factors (e.g. atrial fibrilation due to infectious disease causing embolic stroke) may be more contributive than searching for proof of a rare disease (vasculitis) with invasive procedures in this population. Giant cell (temporal) arteritis is the only vasculitis specifically related with age; the vital prognosis of vision may be compromised. Corticosterid therapy must be instituted without delay. Periartritis nodosa begins in 30% of cases after 60 years of age. The clinical features are the same as in younger subjects. Other vasculidis are rare in the elderly. In absence of specific studies in this population, therapeutic protocols are the same as in younger subjects but may have to be adjusted.

Publication types

  • English Abstract
  • Review

MeSH terms

  • Aged
  • Giant Cell Arteritis / diagnosis
  • Giant Cell Arteritis / therapy
  • Humans
  • Peripheral Nervous System Diseases* / diagnosis
  • Peripheral Nervous System Diseases* / etiology
  • Peripheral Nervous System Diseases* / therapy
  • Polyarteritis Nodosa / diagnosis
  • Polyarteritis Nodosa / therapy
  • Prognosis
  • Vasculitis, Central Nervous System* / diagnosis
  • Vasculitis, Central Nervous System* / etiology
  • Vasculitis, Central Nervous System* / therapy