What is CNS lupus?

Updated: May 04, 2021
  • Author: Pradeep C Bollu, MD; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM  more...
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Neurologic manifestations are among the features of systemic lupus erythematosus (SLE), a multisystem autoimmune connective tissue disorder with various clinical presentations. SLE affects many organ systems, including the central and peripheral nervous systems and muscles. [1]

Central nervous system (CNS) lupus is a serious but potentially treatable illness, which still presents very difficult diagnostic challenges (see the following image). This condition is in the differential diagnosis for many neurologic conditions. Thus, neurologists and other clinicians need to be aware of the various presentations and neurologic complications of SLE; patients with SLE often have neurologic symptoms, and SLE is sometimes diagnosed after patients present for treatment of a neurologic event. [2, 3]

This axial, T2-weighted brain magnetic resonance i This axial, T2-weighted brain magnetic resonance image (MRI) demonstrates an area of ischemia in the right periventricular white matter of a 41-year-old woman with longstanding systemic lupus erythematosus (SLE). She presented with headache and subtle cognitive impairments but no motor deficits. Faintly increased signal intensity was also seen on T1-weighted images, with a trace of enhancement following gadolinium that is too subtle to show on reproduced images. The distribution of the abnormality is consistent with occlusion of deep penetrating branches, such as may result from local vasculopathy, with no clinical or laboratory evidence of lupus anticoagulant or anticardiolipin antibody. Cardiac embolus from covert Libman-Sacks endocarditis remains less likely due to the distribution.

See also Pediatric Systemic Lupus Erythematosus, Neonatal and Pediatric Lupus Erythematosus, Systemic Lupus Erythematosus and Pregnancy, Discoid Lupus Erythematosus, Bullous Systemic Lupus Erythematosus (BSLE), Acute Cutaneous Lupus Erythematosus (ACLE), Subacute Cutaneous Lupus Erythematosus (SCLE), and Physical Medicine and Rehabilitation for Systemic Lupus Erythematosus.

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