Health Questions and Answers

Question: What are the neuropsychiatric manifestations of SLE?


Because of the difficulty in establishing an unequivocal diagnosis, rates of CNS features cross a broad range. Neuropsychiatric manifestations of lupus may occur in around 70% of patients. Examples include psychosis (5%); cranial, autonomic, and peripheral neuropathies; migraine headaches; seizure; aseptic meningitis; pseudotumor cerebri; chorea; and cerebral infarction. Rarely, transverse myelitis has been observed. Organic brain syndromes are easier to recognize in lupus when they are profound (delirium) but now are recognized more frequently as changes in mentation, such as mild memory loss and impaired concentration. The more subtle features of cognitive dysfunction may be the most common CNS syndrome in SLE. Abnormal SPECT or PET scanning and decreasing intellectual function, as measured by a standard battery of neurocognitive function tests, are present. The cause for this problem is not known, but cytokines are believed to play an important role. 

Reference: Wallace DJ, Metzger AL: Systemic lupus erythematosus: Clinical aspects and treatment. In Koopman WJ (ed): Arthritis and Allied Conditions: A Textbook of Rheumatology, 13th ed. Baltimore, Williams & Wilkins, 1997, pp 1319-1345. 

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