2001 issue 2

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Volume 10, issue 2

Systemic connective tissue diseases

Early symptoms of the nervous system involvement in patients with systemic lupus erythematosus (SLE)

ZYTA BANECKA-MAJKUTEWICZ1, LEOKADIA DOBRZYŃSKA2, MAŁGORZATA KRZEŚNIAK-BOHDAN2, MIROSŁAWA KOSEDA2
1. Kliniki Neurologii Dorosłych Akademii Medycznej w Gdańsku
2. Katedry i Zakładu Medycyny Rodzinnej Akademii Medycznej w Gdańsku
Postępy Psychiatrii i Neurologii, 2001, 10, 137-143
Keywords: systemic lupus erythematosus, CNS-lupus, nervous system

Abstract

The aim of the study was to analyse early manifestations of the nervous system involvement so that cerebral SLE can be early diagnosed and successfully treated before the onset of irreversible changes. Special attention was paid to the presence of risk factors (such as hypertension, diabetes mellitus, heart and renal failure, dyslipidemia, and large doses of steroid therapy), that may contribute to the nervous system lesions. 44 patients with SLE were reviewed retrospectively. Their mean age was 43.8± 11.5 years (range 22-68), while the mean duration of SLE evolution was 11.8±9.0 years (range 1-30). In 28 cases clinical evidence of the nervous system involvement was found. In 9 patients neurological abnormalities heralded other SLE signs and symptoms, in other 7 cases neurological symptoms occurred in the first year following the diagnosis of SLE, while in 12 patients – later in the course of the disease. Neurological disorders that appear either prior to other manifestations of SLE or in the first year after the diagnosis, included: headache and vertigo (in 7 and 4 cases, respectively), organic brain syndrome (4 cases), seizures (3 cases), focal CNS lesions (3 cases). Renal diseases were found in 62.5% patients with early neurological disorders, hypertension in 40%, heart diseases in 33.3% of the patients, and haematological disorders in 27.7% of cases. Conclusions: (l) Symptoms of CNS lesions in SLE may precede other SLE manifestations, so in young patients with neurological disorders of unknown origin a diagnostic examination for SLE should be performed. (2) Early neurological disorders are usually transient and unspecific: headache, vertigo, organic brain syndrome. (3) Special care should be provided to SLE patients suffering from hypertension and renal diseases, since these two factors predispose to the development of neurological disorders.

Address for correspondence:
Dr Zyta Banecka-Majkutewicz,
Klinika Neurologii Dorosłych Akademii Medycznej,
ul. Dębinki 7,
80-952 Gdańsk