Neurological syndromes in systemic lupus erythematosus and their association with antiphospholipid syndrome.

BACKGROUND AND PURPOSE: In patients with systemic lupus erythematosus (SLE), severe neurological syndromes indicating central, peripheral or autonomic nervous system involvement are frequently seen. Antiphospholipid syndrome (APS) increases the risk of nervous system involvement. The aim of the study was to assess neurological manifestations occurring in patients with SLE and to evaluate their association with APS.

MATERIAL AND METHODS: One hundred thirty-seven patients (123 women and 14 men) with SLE were studied. Fifty out of 137 patients (43 women and 7 men) were diagnosed with APS. All patients underwent full neurological examination and diagnostics. Neurological syndromes were classified according to the standardized American College of Rheumatology (ACR) nomenclature.

RESULTS: Neurological syndromes were found in 89 cases out of 137 admitted SLE patients (64.96%). Headache was present in 52 patients (37.96%), polyneuropathy in 17 (12.41%), cerebrovascular disease in 13 (9.49%), seizures in 10 (7.3%), cranial neuropathy in 5 (3.65%), demyelinating syndrome in 5 (3.65%), mononeuropathy in 3 (2.19%), movement disorder in 3 (2.19%), and aseptic meningitis in 2 patients (1.46%). Our study indicated that 78% of patients with APS showed nervous system involvement as compared with 57.47% of SLE patients without APS (p=0.01).

CONCLUSIONS: Neurological syndromes occurring most frequently in SLE patients include headache, polyneuropathy and cerebrovascular diseases. Antiphospholipid syndrome increases the risk of nervous system involvement. We found that APS was strongly associated with neurological manifestations and in particular with cerebrovascular diseases and seizures.