Epileptic seizures in systemic lupus erythematosus

Appenzeller, Simone; Cendes, Fernando; Costallat, Lilian T. L.

doi:10.1212/01.wnl.0000144178.32208.4f

Cited by 157 publications

(137 citation statements)

References 27 publications

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“…4,5 NPSLE manifestations are extremely variable and include features of both psychiatric and neurological dysfunction. [4][5][6][7][8][9] Psychiatric manifestations may include cognitive dysfunction, anxiety, mood and personality disorders, and psychosis. 5,6 The commonest neurological manifestations include headache, stroke, seizure, and peripheral neuropathy.…”

Section: Discussionmentioning

confidence: 99%

“…5,6 The commonest neurological manifestations include headache, stroke, seizure, and peripheral neuropathy. 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.…”

Section: Discussionmentioning

confidence: 99%

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

AlTahan¹

2018

JNSK

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Submit Manuscript | http://medcraveonline.com with mobility. Otherwise she did not have any systemic complaints. Had no history of a recent infectious illness and did not use any medication. Her past and family history was unremarkable. On examination, she was alert, fully oriented with intact cognitive functions. The movements were noted as involuntary, rapid and purposeless generalized movements. She could not control it and had difficulty stabilizing her head. Auscultation revealed pansystolic murmur over the apex. She had no skin lesion, joint tenderness or swelling. Blood investigations showed normochromic normocytic anemia with thrombocytopenia (Hb: 8g/dl, MCV: 80 fl, WBCs: 4.5×10 9 Platelets: 84×10 9 ). Had normal renal and liver functions. Coombs test was positive, ANA and anti-dsDNA Abs were positive. Furthermore her cardiolipin IgG was positive (36.9 U/ml) and urine analysis shows hematuria (20-30/HPF) and proteinuria (100 mg/dl). Brain MRI demonstrated multiple bilateral old and recent ischemic lesions (Figure 1). Echocardiography show mildly thickened mitral valve with prolapsed of anterior segments of mitral leaflet & moderate mitral regurgitation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

AlTahan¹

2018

JNSK

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“…A single isolated seizure is more frequently seen and a generalized tonic-clonic seizure is the most common type (67% to 88%), but a simple partial and complex seizure can also occur 8 . Abnormalities on the EEG are common (60% to 70%) in SLE, and epileptiform EEG patterns suggest the seizure is likely to recur (73% positive predictive value, 79% negative predictive value) 24 . Patients with seizures show more gray matter hyperintensities on MRI images and may develop brain atrophy 13 .…”

Section: Seizuresmentioning

confidence: 99%

“…Inflammatory processes are believed to play a major role in the pathogenesis of epileptic seizures 25 . Ischemic vascular disease and antibodies that bind to cerebral tissues such as anticardiolipin and anti-Sm have been associated with seizures 24 . Epilepsy in SLE has also been associated with APS, disease activity, multiple NPSLE manifestations (i.e., psychosis, stroke), and severe baseline organ damage 24,26 .…”

Section: Seizuresmentioning

confidence: 99%

Neuropsychiatric Lupus in clinical practice

Alessi

Dutra

Neto

et al. 2016

Arq. Neuro-Psiquiatr.

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Systemic lupus erythematosus (SLE) is a chronic autoimmune disease involving multiple organs, characterized by the production of autoantibodies and the development of tissue injury. The etiology of SLE is partially known, involving multiple genetic and environmental factors. As many as 50% of patients with SLE have neurological involvement during the course of their disease. Neurological manifestations are associated with impaired quality of life, and high morbidity and mortality rates. Nineteen neuropsychiatric syndromes have been identified associated with SLE, and can be divided into central and peripheral manifestations. This article reviews major neuropsychiatric manifestations in patients with SLE and discusses their clinical features, radiological findings and treatment options.

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“…The pathogenesis of NPSLE is multifactorial and involves various inflammatory cytokines, autoantibodies, and immune complexes resulting in vasculopathic, cytotoxic and autoantibody-mediated neuronal injury [111]. In one series of 518 consecutive patients with SLE, 88 SLE patients (17%) had epileptic seizures, 60 (11.6%) were considered as primary manifestation of SLE, 23 (4.4%) were secondary acute metabolic causes, and 5 (1%) had epilepsy prior to the diagnosis of SLE [112]. Different treatment regimens include nonsteroidal anti-inflammatory drugs, anticoagulation, and immunosuppressives such as cyclophosphamide, azathioprine, mycophenolate mofetil, and methotrexate.…”

Section: Roles Of Immune and Inflammation In Drementioning

confidence: 99%

Modulation of Immunity and the Inflammatory Response: A New Target for Treating Drug-resistant Epilepsy

Líu²,

Qin³

2013

Current Neuropharmacology

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Until recently, epilepsy medical therapy is usually limited to anti-epileptic drugs (AEDs). However, approximately 1/3 of epilepsy patients, described as drug-resistant epilepsy (DRE) patients, still suffer from continuous frequent seizures despite receiving adequate AEDs treatment of sufficient duration. More recently, with the remarkable progress of immunology, immunity and inflammation are considered to be key elements of the pathobiology of epilepsy. Activation of inflammatory processes in brain tissue has been observed in both experimental seizure animal models and epilepsy patients. Anti-inflammatory and immunotherapies also showed significant anticonvulsant properties both in clinical and in experimental settings. The above emerging evidence indicates that modulation of immunity and inflammatory processes could serve as novel specific targets to achieve potential anticonvulsant effects for the patients with epilepsy, especially DRE. Herein we review the recent evidence supporting the role of inflammation in the development and perpetuation of seizures, and also discuss the recent achievements in modulation of inflammation and immunotherapy applied to the treatment of epilepsy. Apart from medical therapy, we also discuss the influences of surgery, ketogenic diet, and electroconvulsive therapy on immunity and inflammation in DRE patients. Taken together, a promising perspective is suggested for future immunomodulatory therapies in the treatment of patients with DRE.

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Epileptic seizures in systemic lupus erythematosus

Cited by 157 publications

References 27 publications

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

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

Neuropsychiatric Lupus in clinical practice

Modulation of Immunity and the Inflammatory Response: A New Target for Treating Drug-resistant Epilepsy

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