What are the signs and symptoms of cranial nerve involvement in 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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Cranial nerve involvement is also relatively uncommon and usually transient, [16] occurring in 10% of patients with SLE. Oculomotor nerve palsies and all other cranial neuropathies have been reported. Visual disturbances tend to be bilateral (80%) and to occur late in the disease course (77%); these include optic neuritis, retinopathy, and concurrent migrainous features. Anterior segment findings include keratoconjunctivitis sicca, keratitis, and scleritis. Retinopathy can be associated with cotton wool exudates (indicative of local retinal ischemia) and hemorrhages. [15, 17, 18]

Lee et al reported a case of SLE with recurrent laryngeal palsy resulting in vocal cord paresis. Laryngeal electromyography (LEMG) on both cricothyroid and thyroarytenoid muscles confirmed a left recurrent laryngeal neuropathy with ongoing processes of denervation and reinnervation. [19]

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