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


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.
Honczarenko
Krystyna
K
Pomorska Akademia Medyczna w Szczecinie, Klinika Neurologii, ul. Unii Lubelskiej 1, 71-252 Szczecin.
Budzianowska
Anna
A
Ostanek
Lidia
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D016736:Antiphospholipid Syndrome / Q000453:epidemiology*; D002561:Cerebrovascular Disorders / Q000453:epidemiology; D015897:Comorbidity; D003389:Cranial Nerve Diseases / Q000453:epidemiology; D003711:Demyelinating Diseases / Q000453:epidemiology; D005260:Female; D006261:Headache / Q000453:epidemiology; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination / Q000706:statistics & numerical data; D011044:Poland / Q000453:epidemiology; D012189:Retrospective Studies; D018570:Risk Assessment; D012640:Seizures / Q000453:epidemiology; D012720:Severity of Illness Index; D055815:Young Adult