CNS lupus

Abstract

Our observations, particularly the emergence of non-choreic movement disorders, the blood, serum, and imaging findings, and the prognostic importance of CSF abnormalities, should help improve both the recognition of CNS systemic lupus erythematosus, perhaps particularly in elderly individuals, and its management.

Approach to Patients with SLE Presenting with Neurological Findings

“…Two studies have shown a protective effect of arthritis to CNS disease ((EULAR, 2010). This was not consistent in other study were arthritis was a second common manifestation after skin disease (Joseph et al,2007).…”

“…The prevalence of other NPSLE syndromes is much less with reported prevalence of demyelinating syndrome and movement disorder of 1%. CNS manifestations present as an initial feature of SLE in 24% of cases (Joseph et al,2007). In general around 50-60% of NPSLE occurred at disease onset or within the first year after SLE onset.…”

Generalized chorea as the first presentation of systemic lupus erythematosus: case report and review of literature

“…4,[7][8][9] Other less common features include cranial neuropathies, transverse myelitis, meningitis, and movement disorders which occur in less than 5% of patients and include chorea, ataxia, choreoathetosis, dystonia, and hemiballismus. [10][11][12] Chorea accounts only for about 2% of all NPSLE manifestations, which qualified it as a clinical diagnostic challenge. 12 In practice, the differential diagnosis of chorea is wide and include a long list of hereditary and non-hereditary disorders.…”

Magnetic Resonance Imaging in Neuropsychiatric Lupus

“…With DWI sequences it is possible to determine if they are in the acute, subacute or chronic stage, including silent infarcts. Large vessel infarcts are one of the most debilitating complications of NPSLE, and are found in 10–15% of patients and at a mean age of 35–40 years 8, 22, 24, 25 . When infarcts occur in NPSLE, a tendency to multiplicity was noticed, which is translated into a high recurrence of ischemic events 8 .…”

“…Middle cerebral artery territory is mainly involved, as in the general population 8 . Many authors associated antiphospholipid antibodies with infarcts and reported a stroke recurrence of around 50% when these antibodies were present 22, 24, 26 . Stroke was also more commonly observed in the presence of hypertension, cerebrovascular syndrome and seizures 5 .…”