Acute Neurolupus Manifested by Seizures Is Associated with High Frequency of Abnormal Cerebral Blood Flow Velocities

Baizabal‐Carvallo, José Fidel; Cantú-Brito, Carlos; Garcı́a-Ramos, Guillermo

doi:10.1159/000118381

Cited by 7 publications

(6 citation statements)

References 52 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, in a prospective study with patients followed for a mean of 4.5 years, new ischemic events did not occur more frequently in patients with positive MES at baseline [6]. In addition, in another study conducted by our team, MES were not observed more frequently in patients with acute neurological manifestations, including seizures and stroke, although the number of cases was small [4].…”

Section: Systemic Lupus Erythematosusmentioning

confidence: 63%

See 1 more Smart Citation

Microembolic signals in systemic lupus erythematosus and other cerebral small vessel diseases

Baizabal‐Carvallo¹,

Samson²

2009

J Neurol

Self Cite

View full text Add to dashboard Cite

Microembolic signals (MES) are detected by transcranial Doppler (TCD), and are mainly observed in cardiac and large-artery diseases; however they might also be observed in conditions affecting small vessels of the brain. We aimed to review the current medical literature related to MES assessed by TCD in patients with cerebral small vessel disease. We conducted a systematic review in PubMed and selected the articles with information on this topic. Systemic lupus erythematosus (SLE) is the disease with more articles; pooled data showed a frequency of MES of 14.9%. MES were more frequent in SLE patients with antiphospholipid antibodies and ischemic stroke. MES have also been described in other diseases such as primary antiphospholipid syndrome, Sneddon's syndrome, and Behçet's disease. Further studies assessing the significance of MES in the pathogenesis of neurological manifestations of these disorders is warranted.

show abstract

Section: Systemic Lupus Erythematosusmentioning

confidence: 63%

“…Results from five studies [4,6,11,34,47] show that patients with MES (?) have a stroke more frequently associated: 36/57 than MES (-) patients: 26/ 272, OR: 2.19; 95% CI: 1.63-2.95, P \ 0.001.…”

Section: Systemic Lupus Erythematosusmentioning

confidence: 99%

Microembolic signals in systemic lupus erythematosus and other cerebral small vessel diseases

Baizabal‐Carvallo¹,

Samson²

2009

J Neurol

Self Cite

View full text Add to dashboard Cite

show abstract

“…8 The PI is an important haemodynamic parameter that linearly correlates with cerebral microvascular tone, blood flow resistance and impedance. 8 Other studies have evaluated PI in patients with SLE 40,49 and APS 6 and found no differences when compared with healthy volunteers. 6 In our series, patients with APS (either PAPS or SAPS) had a trend to present more intracranial stenosis than healthy volunteers.…”

Section: Discussionmentioning

confidence: 99%

“…6 High MFVs were also found in two other studies in patients with SLE, suggesting the presence of a diffuse cerebral vasculopathy. 48,49 It is well known that other factors could explain higher velocities in patients with SLE rather than only a vasculopathy. Several physiologic variables can impact blood flow velocities measured by TCD, including age, gender, hematocrit levels, body temperature, blood pressure and mental or motor activity.…”

Section: Discussionmentioning

confidence: 99%

Transcranial Doppler findings in antiphospholipid syndrome

Ricarte

Dutra

Barsottini

et al. 2019

Lupus

View full text Add to dashboard Cite

Introduction Transcranial Doppler is a method that enables the assessment of different cerebral hemodynamic parameters. It also allows for the evaluation of the presence of right-to-left circulation shunts (RLS) and for the detection of microembolic signals (MESs), which might be associated with an increased risk of cerebrovascular events. For instance, the presence of MESs on transcranial Doppler in patients with systemic lupus erythematous (SLE) and antiphospholipid syndrome (APS) is associated with an increased risk of stroke. Therefore, transcranial Doppler could be a useful tool for stroke risk stratification in these patients. Objective Our objective was to evaluate transcranial Doppler cerebral mean blood flow velocities as well as the presence of MESs and RLS in patients with antiphospholipid syndrome and SLE. Patients and methods Twenty-two patients with primary APS (PAPS), 24 patients with secondary APS (SAPS), 27 patients with SLE without APS and 21 healthy controls were evaluated. Clinical and epidemiological data were compiled from medical charts, and all subjects underwent transcranial Doppler examination with breath-holding index calculation. Both middle cerebral arteries were monitored for 60 min for the detection of MESs. RLS was investigated with agitated saline injected as a bolus. Results There were no significant differences in mean blood flow velocities among the groups. MESs were more frequently found in patients with SLE when compared with controls and patients with APS (SLE: 17.4%, SAPS: 4.3%, PAPS: 0%, controls: 0%, p = 0.03). Anticoagulant therapy was more frequently used in the APS group (PAPS: 81.8%, SAPS: 75.2%, SLE: 1.7%, p < 0.001). Patients with APS had a higher frequency of RLS when compared with volunteers (63.6% versus 38.1%, p = 0.05). Breath-holding index values tended to be lower in patients with SAPS than in control subjects and patients with PAPS and SLE ( p = 0.06). Conclusions Patients with APS had a higher frequency of RLS than healthy controls. This finding alerts to the importance of cardiac investigation in patients with stroke and APS, because further therapies such as RLS occlusion might eventually add protection. The higher frequency of MES in patients with SLE could suggest an effect of anticoagulant therapy on MES prevention, more frequently used in patients with APS.

show abstract

“…Seizures are found in 15e20% of SLE patients [70,71]. These can be the result of the disease process, such as lupus vasculitis or acute thrombosis, steroid therapy and its attendant hypertension, or a resulting metabolic problem such as uremia [65] or infection.…”

Section: Clinical Involvement Of the Central Nervous Systemmentioning

confidence: 99%

The Clinical Presentation of Systemic Lupus Erythematosus

Lahita¹

2011

Systemic Lupus Erythematosus

View full text Add to dashboard Cite

Acute Neurolupus Manifested by Seizures Is Associated with High Frequency of Abnormal Cerebral Blood Flow Velocities

Cited by 7 publications

References 52 publications

Microembolic signals in systemic lupus erythematosus and other cerebral small vessel diseases

Microembolic signals in systemic lupus erythematosus and other cerebral small vessel diseases

Transcranial Doppler findings in antiphospholipid syndrome

The Clinical Presentation of Systemic Lupus Erythematosus

Contact Info

Product

Resources

About