title: Neurological Manifestations in Systemic Lupus Erythematosus: A Single Centre Study from North East India.
abstract: BACKGROUND
  Neurological manifestations although common in Systemic Lupus Erythematosus (SLE), are often not recognized due to their diversed and varied presentation. Therefore, the study was planned to highlight the pattern of neurological involvement in SLE to help in early recognition.
  
  
  OBJECTIVE
  To study the pattern of neurological involvement in SLE and its correlation with disease activity and different investigation.
  
  
  METHODS
  This hospital based prospective observational study was carried out from August 2009 to July 2010. Diagnosed cases of SLE [based upon American Rheumatism Association (ARA) criteria] who presented with neurological manifestations at the time of diagnosis or develop during the course of the disease were included in the study. They were assessed clinically and investigated with neuroimaging and neurophysiological tests as applicable.
  
  
  RESULTS
  In total, 52 consecutive patients with SLE were evaluated, 92% were female. The most common age group was 21 to 25 years. Nervous system involvement was found in 19 (36.54%) patients. Cognitive impairment was the most frequent manifestation, present in 11 (57.89%) patients followed by seizure disorder in eight patients (42.1%). Peripheral neuropathy was diagnosed in eight (42.1%), acute confusional state in six (31.57%) and headache and depression was diagnosed in five (26.31%) patients each. Less common manifestations were psychosis, movement disorder and aseptic meningitis. Percentage of neurological manifestations directly correlated with disease activity. A significant difference was found in Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score between the patients with Neuro Psychiatric Systemic Lupus Erythematosus (NPSLE) and those without NPSLE (32.42±16.34 Vs 17.3±10.6).
  
  
  CONCLUSIONS
  Neurological involvement in SLE is seen relatively early in the course of the disease with cognitive impairment being the most common manifestation and correlate with disease activity.
authors.affiliation: Professor, Department of Medicine, Assam Medical College , Dibrugarh, Assam, India .
authors.forename: Sanjeeb
authors.initials: S
authors.lastname: Kakati
authors.affiliation: Associate Professor, Department of Medicine, NEIGRIHMS , Shillong, Meghalaya, India .
authors.forename: Bhupen
authors.initials: B
authors.lastname: Barman
authors.affiliation: Postgraduate Student, Department of Medicine, Assam Medical College , Dibrugarh, Assam, India .
authors.forename: Sobur U
authors.initials: SU
authors.lastname: Ahmed
authors.affiliation: Assistant Professor, Department of Neurology, NEIGRIHMS , Shillong, Meghalaya, India .
authors.forename: Masaraf
authors.initials: M
authors.lastname: Hussain
keywords: Acute confusional state; Cognitive impairment; Neurolupus; Seizure