Reversible focal neurological deficits in systemic lupus erythematosus: Report of 2 cases and review of the literature

Posterior reversible encephalopathy syndrome could be an underestimated variant of “reversible neurological deficits” in Systemic Lupus Erythematosus

“…SLE patients might develop reversible focal neurological deficits, which responded to steroid therapy (Figure  4) [13,40-42]. On the other hand, though the subcortical and deep white matter of the posterior circulation supplied regions of the brain were usually affected in PRES, involvement of the brainstem, cerebellum, basal ganglia, frontal and temporal lobes and the cortex had also been reported in up to 56% in patients with clinical features of PRES [8,43-46].…”

“…PRES could be associated with several conditions, including hypertensive encephalopathy, eclampsia, immunosuppressive drugs and inflammatory disorders, and was reversible if treated promptly [8-12]. Literature review showed that severe hypertension (> 170/110 mmHg) and renal failure were present in the majority of previously reported cases of SLE with PRES, whereas SLE patients might also develop reversible focal deficits that respond to steroid therapy [13]. The peculiar role of SLE itself in the occurrence of PRES was not clear since PRES could be a manifestation of lupus disease activity or a consequence of immunomodulatory therapy, making the diagnosis and treatment challenging.…”

Brain MRI in patients with acute confusional state of diffuse psychiatric/neuropsychological syndromes in systemic lupus erythematosus

“…MRI abnormalities decreased or disappeared after treatment in all the ACS patients that survived and even in four patients who died, suggesting that these brain MRI abnormalities resulted from reversible lesions, possibly due to vasculitis [16,25]. By contrast, MRI abnormalities did not improve in the other 4 fatal patients.…”

Reversible basal ganglia lesions in neuropsychiatric lupus: a report of three pediatric cases

“…Reversible involvement of the basal ganglia has rarely been reported in pediatric cases of SLE. Kimura et al …”

“…Reversible involvement of the basal ganglia has rarely been reported in pediatric cases of SLE. Kimura et al 13 reported on reversible focal neurological manifestations, including CVD manifestations, in SLE. Furthermore, posterior reversible encephalopathy syndrome (PRES) has been described in many conditions, including hypertension, eclampsia, renal failure, immunosuppressant drugs and autoimmune diseases, particularly SLE.…”