Systemic Lupus and the Nervous System

Some interesting reading.

Systemic Lupus and the Nervous System

Daniel J. Wallace, M.D.
Clinical Chief of Rheumatology,
Cedars Sinai Medical Center,
Associate Clinical Professor of Medicine,
University of California at Los Angeles,
Los Angeles, CA

The Antiphosholipid Syndrome

One-third of all people with lupus have a false positive syphilis test, a positive antisardiolipin antibody or a prolonged clotting time test called the PTT.  This is known as the lupus anticoagulant or the antiphospholipid antibody.

One-third of these patients (one-ninth or all people with lupus) will develop blood clots in various parts of the body.  these patients have the antiphospholipid syndrome.  When a blood clot occurs in the nervous system, it can cause a stroke.  Symptoms of stroke usually include the painless onset of neurologic deficits (e.g., paralysis on one side of the body, inability to speak) without any signs of active lupus.  A stoke is managed with blood thinning medications such as low dose aspirin, coumadin or heparin.  The type of blood vessel involved and presenting symptoms are considered when determining which medical therapy should be used.

Organic Brain Syndrome

Patients with a history of stroke or vasculitis experience damage to the brain that is repaired by scar tissue.  This results in seizures as well as varying degrees of difficulty with muscular movement, memory, concentration and orientation.  these patients have organic brain syndrome and usually show evidence of lupus activity in the blood or spinal fluid.  Steroids make the symptoms worse.  Organic brain syndrome is treated with emotional support.