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Neurocognitive dysfunction in the eosinophilia-myalgia syndrome
L B Krupp1, D M Masur, L D Kaufman
1Department of Neurology, State University of New York, Stony Brook 11794.
Neurology
|May 1, 1993
Summary
Eosinophilia-myalgia syndrome (EMS) patients frequently experience objective cognitive deficits, including memory and reasoning impairments. These findings suggest EMS may involve an encephalopathy alongside its known peripheral neuropathy.
Area of Science:
- Neurology
- Immunology
- Toxicology
Background:
- Eosinophilia-myalgia syndrome (EMS) is a serious multisystem disorder linked to L-tryptophan supplements.
- Patients often report cognitive difficulties, but objective evidence of neurocognitive impairment is less understood.
Purpose of the Study:
- To quantify neurocognitive deficits in EMS patients with subjective cognitive complaints.
- To explore correlations between cognitive impairment and demographic factors, eosinophilia, and psychiatric diagnoses.
Main Methods:
- A comprehensive neuropsychological test battery was administered to 24 EMS patients and 32 healthy controls.
- EMS patients also underwent psychiatric interviews and rheumatologic evaluations.
Main Results:
- 62% of EMS patients (15 of 24) exhibited objective neurocognitive deficits.
- EMS patients showed significant impairments in verbal memory, visual memory, conceptual reasoning, and motor speed compared to controls.
- Cognitive impairment was not associated with demographic factors, eosinophil levels, neuropathy, or psychiatric disorders.
Conclusions:
- EMS is associated with central nervous system involvement (encephalopathy) beyond peripheral neuropathy.
- Neurocognitive deficits are a significant manifestation of EMS, impacting multiple cognitive domains.