Some controversies of neuropsychiatric systemic lupus erythematosus

  title={Some controversies of neuropsychiatric systemic lupus erythematosus},
  author={Roald Omdal},
  journal={Scandinavian Journal of Rheumatology},
  pages={192 - 197}
  • R. Omdal
  • Published 1 January 2002
  • Psychology, Medicine
  • Scandinavian Journal of Rheumatology
Systemic lupus erythematosus (SLE) is accompanied by several features that can be attributed to involvement of the central or peripheral nervous system. The etiology and pathogenesis of these manifestations are mostly unknown. To which degree these neuropsychiatric conditions can be explained on the basis of chronic illness, or as part of the disease spectrum of SLE, is also a matter of debate. Some of the controversial issues on these matters are discussed in the article. 

Systemic Lupus Erythematosus: A Review

Basic fundamentals of systemic lupus erythematosus are dealt with, the epidemiology, the pathology of the disease, the sign and symptoms of the Disease, the current therapy available and scope of research in this field.

[Neuropsychiatric systemic lupus erythematosus: where are we now?].

The introduction of the concept of "borderline cases", proposed by Italian Study Group for NP-SLE, is based both on clinical and instrumental evaluation and could represent a useful tool when dealing with conditions which do not fulfil ACR classification.

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Vasculitis in Juvenile-Onset Systemic Lupus Erythematosus

This review will focus on the presentation, diagnosis, management and outcomes of vasculitis in JSLE, highlighting gaps in the current evidence base.

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Systemic lupus erythematosus in Tunisia: demographic and clinical analysis of 100 patients

The demographic, clinical and laboratory characteristics of SLE Tunisian patients are demonstrated and those at high risk for renal and neuropsychiatric involvement are identified and identified.

Microembolic Signals in Patients with Systemic Lupus Erythematosus

Microembolic signals (MES) may be a predictor for CNS involvement in SLE patients at risk for neuropsychiatric syndromes, and Cerebral embolism may be implicated in the pathophysiology of Neuropsychiatric SLE.

Detection of cerebral embolic signals in patients with systemic lupus erythematosus

A significant association was found between MES and cerebral infarcts and considerably more neuropsychological deficits were found in MES-positive patients compared with the negative group, suggesting a complex pathogenesis for the embolisation in these patients.

Clinical Presentation of Pediatric SLE at Outpatient Clinic

Nephropathy, fever, anorexia and arthralgia were the most common presenting clinical manifestations in pediatric patients and alertness to the possibility of SLE as diagnosis in patients with variable manifestation should be raised.

The blood-brain barrier in systemic lupus erythematosus

Evidence that damage to the brain endothelium forming the blood-brain barrier (BBB) is a contributoryfactor in systemic lupus erythematosus or NPSLE is summarized.



Neuropsychiatric lupus.

Diagnosis and therapy of neurologic disease remain the most difficult clinical challenges in the management of SLE.

Brain scan diagnosis of central nervous system involvement in systemic lupus erythematosus.

Twenty-five patients with 29 episodes of active systemic lupus erythematosus with central nervous system involvement were studied and Serial brain scanning was found to be useful in the diagnosis of exacerbations and the monitoring of corticosteroid dosage.

Migrainous phenomena in systemic lupus erythematosus.

The data suggest that migraine-like phenomena may arise as a result of vascular dysfunction in SLE, and corticosteroids were more effective than conventional antimigraine therapy in controlling headaches and scotomas.

Clinical neuropsychiatric and neuromuscular manifestations in systemic lupus erythematosus.

Thirty patients with SLE were studied retrospectively and subjected to clinical neurological examination, finding that migraine was the most frequent single symptom, followed by severe protracted headache, vertigo, and psychiatric problems in patients.

Systemic lupus erythematosus. A prospective analysis.

A more conservative approach than has been generally recommended was used for the management of systemic lupus erythematosus and is supported by the estimated 5-year survival of 98%.

Nervous system involvement in systemic lupus erythematosus

In a retrospective analysis of 80 patients with systemic lupus erythematosus (SLE) seen over a 10-year period, 41 (51%) exhibited neurological manifestations and nervous system involvement was characterized by a significantly greater involvement of black patients and a higher incidence of renal failure after the first appearance of neurological features.

Nervous system lupus: pathogenesis and rationale for therapy.

Results, both in animal models and in human studies on the therapeutic effects of corticosteroids, immunosuppressive drugs or anticoagulants on clinical and subclinical manifestations of CNS lupus are highlighted in an attempt to develop a rationale for intervention based upon presumed pathogenesis.

Clinical and neuropathological findings in systemic lupus erythematosus: The role of vasculitis, heart emboli, and thrombotic thrombocytopenic purpura

It is indicated that cardiac emboli from Libman‐Sacks endocarditis and TTP are common pathogenetic factors of CNS disease in systemic lupus erythematosus, whereas CNS vasculitis is rare.

The antiphospholipid syndrome

  • E. Harris
  • Medicine, Biology
    Clinical reviews in allergy & immunology
  • 1995
Clinically, major characteristics of the disorder have been defined, but the course of the disease and its relationship to other disorders, such as systemic lupus erythematosus (SLE), need to be defined.


Results suggest that autoantibodies which have previously been associated with nervous system manifestations of SLE are not likely to be directly involved in the pathogenesis of cognitive dysfunction.