When should SLE/CNS lupus be considered in patients presenting with neurologic symptoms?

Updated: May 04, 2021
  • Author: Pradeep C Bollu, MD; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM  more...
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Answer

Neurologic syndromes are often present at SLE presentation, and SLE should be considered in the following individuals:

  • Young patients with new-onset confusional or psychiatric states, stroke, or parkinsonism

  • Patients presenting with a multifocal process affecting the CNS, especially if both CNS (e.g., patients carrying the presumptive diagnosis of multiple sclerosis) and peripheral nervous systems (PNS) are affected

  • Patients with cranial neuropathies

  • Patients with noncompressive myelopathies

  • Patients with chorea, unexplained ataxia, myopathy, or polyneuropathy

Microembolic signals have been well recognized in SLE with CNS involvement. Azarpazhooh et al reported microembolic signals in patients with SLE at risk for neuropsychiatric syndromes. [22] Cerebral embolism is further speculated to be implicated in the pathophysiology of SLE with neuropsychiatric syndrome.


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