Long-term outcome of status epilepticus-related to systemic lupus erythematosus: An observational study and a systematic review

Mikdashi, Jamal; Krumholz, Allan

doi:10.1016/j.semarthrit.2023.152250

Cited by 1 publication

(7 citation statements)

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“…SE is a prolonged seizure disorder that can manifest as a complication in about 1-2% of patients with SLE [ 8 ]. The publication “Long-term outcome of status epilepticus-related to systemic lupus erythematosus: An observational study and a systematic review” by Mikdashi and Krumholz provides an overview of SE-related to lupus (SE-SLE) and its characteristics, neuroimaging studies, pathophysiology, and clinical outcomes [ 8 ]. The observational study consisted of 40 SE-SLE patients and included cases identified from a single tertiary care hospital and subsequent systematic review.…”

Section: Reviewmentioning

confidence: 99%

“…The authors utilized the International League Against Epilepsy (ILAE) criteria to assign the etiology of SE-SLE into acute symptomatic, progressive symptomatic, remote symptomatic, and cryptogenic/idiopathic causes. The etiology of these symptoms was mainly found to be related to autoimmunity rather than cerebrovascular disease or cryptogenic causes [ 8 ]. Another publication by Rodriguez-Hernandez et al further supports this theory, stating that inflammatory cells and antibodies have a large role in the pathogenesis of seizures in SLE and that understanding these mechanisms is key to developing targeted therapies for such patients [ 9 ].…”

Section: Reviewmentioning

confidence: 99%

“…The authors Mikdashi et al diagnosed SE-SLE using criteria from the International Classification of Epileptic Seizures. It is defined as a seizure event lasting five minutes or longer or as continuous clinical and/or EEG seizure activity or recurrent activity without recovery between episodes [ 8 ]. Diagnostic tools included metabolic panels, CSF studies, brain MRI/MR angiography, and extended EEG monitoring.…”

Section: Reviewmentioning

confidence: 99%

“…SE-SLE findings on imaging commonly showed focal vasculitic lesions associated with cognitive impairment and less commonly seen were reversible MRI abnormalities, cerebral atrophy, and sclerosis. However, the authors concluded that diagnosis of SE-SLE was not associated with any specific imaging results or laboratory abnormalities, including biomarkers [ 8 ].…”

Section: Reviewmentioning

confidence: 99%

“…Intravenous high-dose methylprednisolone was used in all SE-SLE patients, and many patients also required supplementary aggressive immunosuppressive therapies. Follow-up of patients in this observational study ultimately found that long-term outcomes of SE-SLE are poor with a one-year mortality rate of 12.5%, significant in-hospital deaths, recurrent SE-SLE/epilepsy, cognitive impairment, and limited physical function [ 8 ].…”

Section: Reviewmentioning

confidence: 99%

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Neuropsychiatric Systemic Lupus Erythematosus: A Systematic Review

Rice-Canetto,

Joshi,

Kyan

et al. 2024

Cureus

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Neuropsychiatric systemic lupus erythematosus (NPSLE) refers to the neurological and psychiatric manifestations of systemic lupus erythematosus (SLE), which remain poorly understood yet often have a profound effect on the lives of afflicted patients. The aim of this study is to synthesize the available information on the pathogenesis, diagnostics, management, and prognosis of this disease. Our hope is to increase awareness and call for further investigations that may optimize NPSLE patient outcomes and quality of life. We performed a literature review following the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, resulting in 11 studies of inclusion. Within each study, we extracted data on epidemiologic factors, diagnostics, therapeutic modalities, and prognosis for each neuropsychiatric condition. The most widely discussed neuropsychiatric manifestations of SLE based on the American College of Rheumatology (ACR) classifications included status epilepticus (SE) and seizures, transverse myelitis (TM), and cognitive dysfunction. SE and TM had a prevalence of 1-2%, while cognitive dysfunction was nearly 38%. Diagnostics varied depending on symptom presentation but often included brain magnetic resonance imaging (MRI) and antibody testing. Treatment for NPSLE is still widely understudied, but concurrent treatment with immunosuppressants and anti-inflammatories for symptom control and more targeted immunotherapies based on the specific condition is often effective. Prognosis is highly symptom dependent, ranging from a 12.5% one-year mortality in SE and seizure patients to near resolution of symptoms in certain presentations including idiopathic intracranial hypertension and cerebellar ataxia. Further studies are needed to better understand the pathophysiology, diagnostics, and effective therapeutic measures for NPSLE. The severity of these manifestations and generally poor prognosis highlight the need for more research to accurately diagnose and treat this disease. While there is still little data available, this literature review serves to provide updated context on this condition.

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Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

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