Recurrent headache and MRI findings in systemic lupus erythematosus.
BACKGROUND
Headache in patients with systemic lupus eryhtematosus (SLE) is considered a common neurological finding, although the relationship is unclear. Another obscure point is the relationship between headache and neuroradiologic findings in these patients.


OBJECTIVE
In this study, we aimed to evaluate the correlation between headache characteristics and intracranial lesions in SLE patients.


RESULTS
Forty-eight SLE patients were chosen from those referred to our clinic depending on the American Collage of Rheumatology (ACR) criteria at the same time or after the diagnosis of SLE. Headache classification was done regarding the ICD-II criteria in the patients. Headache severity was assessed by visual analog scale (VAS), and subjects with VAS > or = 4 were included in the study. Patients were divided into two groups according to magnetic resonance imaging (MRI) findings: abnormal MRI (lesion positive) and normal MRI (lesion negative). On MRI, intracranial lesions were detected in 37.5% (n = 18) of the patients, and no lesion was found in 62.5% (n = 30). Headache characteristics were as tension type in 54.1% (n = 26) and migraine like in 39.6% (n = 19) of all patients. Imaging findings were mostly as periventricular and subcortical focal lesions, ranging from 3-22 mm in diameter. A significant correlation was found between abnormal MRI findings with advanced age and prolonged disease duration (p = 0.018, p = 0.016).


CONCLUSIONS
As a conclusion, a detailed neurologic evaluation and radiologic investigation, if necessary, should be performed in SLE patients with prolonged disease and advanced age, regardless of headache characteristics.
Bicakci
Sebnem
S
Department of Neurology, School of Medicine, Cukurova University, Balcali Hospital, Adana, Turkey. sebnemb@cu.edu.tr
Ozbek
Suleyman
S
Bicakci
Kenan
K
Aslan
Kezban
K
Kara
Banu
B
Sarica
Yakup
Y
D000328:Adult; D001921:Brain / Q000473:pathology* / Q000503:physiopathology; D001927:Brain Diseases / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D015897:Comorbidity; D004660:Encephalitis / Q000175:diagnosis / Q000503:physiopathology; D005260:Female; D006261:Headache / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D020945:Lupus Vasculitis, Central Nervous System / Q000150:complications* / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D012720:Severity of Illness Index