Central nervous system involvement in systemic lupus erythematosus contributes to more serious course and poor prognosis. Whereas neuropsychiatric lupus is the scantiest recognized aspect of SLE.
Aim of the study: Assessment of neurological syndromes prevalence and its clinical features in patients diagnosed with systemic lupus erythematosus.
Material and methods: The study comprised a group of 44 in- and outpatients of the Department of Dermatology and Venerology of Medical University of Lodz diagnosed with systemic lupus erythematosus and treated in 2006-2007. Each patient was assessed by a neurologist, who took history, performed clinical, neurological examination and, if required, laboratory studies. Systemic lupus activity measure (SLAM) was employed for the assessment of the disease activity. Cumulative dose of administered corticosteroids was calculated retrospectively for each patient, according to medical history.
Results: High prevalence of neurological syndromes was observed in the examined group (77,27%). The most frequent was headache (38,64%). Cerebrovascular disease, prevalent among systemic lupus erythematosus patients (31,82%) was related to more active lupus course. Moreover in the examined group seizures (13,64%), mononeurpathy (13,64%), cognitive impairment (6,82%), polineuropathy (4,55%), cranial neuropathy (2,77%) and acute confusional state (2,27%) were diagnosed. Neurological syndromes were often the first manifestation of systemic lupus erythematosus. There was no relationship observed between the cumulative dose of glucocorticosteroids and the nervous system involvement.
Conclusions: High prevalence of nervous system manifestation in SLE indicates the need for neurological care in SLE patients. Headache is frequent but low specific sign of neuropsychiatric lupus. Neurological disease should incline toward more intense immunosuppressive therapy which may delay the nervous system destruction.