title: Acute neurolupus manifested by seizures is associated with high frequency of abnormal cerebral blood flow velocities.
abstract: BACKGROUND
  Systemic lupus erythematosus may present with a wide variety of neurological manifestations, which could be related to the presence of vasculopathy and microembolic signals (MES).
  
  
  OBJECTIVE
  We aimed to determine the prevalence of MES and altered blood flow velocities (BFVs) by transcranial Doppler (TCD) in patients with acute neuropsychiatric lupus erythematosus (NPLE).
  
  
  METHODS
  Fifteen consecutive patients with acute NPLE (cases) and 30 patients with systemic lupus erythematosus but without acute NPLE (controls) underwent TCD testing for comparison purposes.
  
  
  RESULTS
  We found higher mean BFVs in cases compared with controls in the left (100 vs. 73.5 cm/s, p = 0.018) and in the right (96 vs. 70 cm/s, p = 0.013) middle cerebral arteries. The proportion of MES in both groups was the same (13%). Abnormal TCDs were more frequent in patients with acute NPLE, 67 versus 17% (p = 0.001), and occurred more often in patients who presented seizures.
  
  
  CONCLUSIONS
  The frequency of MES was the same in both groups; however, patients with seizures due to acute NPLE usually present with higher BFVs than controls. This could be a marker of diffuse acute cerebral vasculopathy.
authors.affiliation: Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico. baicarjf@hotmail.com
authors.forename: José Fidel
authors.initials: JF
authors.lastname: Baizabal-Carvallo
authors.forename: Carlos
authors.initials: C
authors.lastname: Cantú-Brito
authors.forename: Guillermo
authors.initials: G
authors.lastname: García-Ramos
mesh_terms: D000293:Adolescent; D000328:Adult; D001783:Blood Flow Velocity / Q000502:physiology; D016022:Case-Control Studies; D002561:Cerebrovascular Disorders / Q000150:complications* / Q000503:physiopathology; D005260:Female; D006801:Humans; D020766:Intracranial Embolism / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000503:physiopathology; D008297:Male; D008833:Microcirculation / Q000503:physiopathology; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D015995:Prevalence; D012640:Seizures / Q000209:etiology* / Q000503:physiopathology; D017585:Ultrasonography, Doppler, Transcranial