Encephalitis and Status Epilepticus in a Patient With Systemic Lupus Erythematosus (original) (raw)
Related papers
2017
We describe a 42-year-old woman with inactive systemic lupus erythematosus (SLE) at the time of her visit. She presented with an atypical movement disorder and partial continuous epilepsy. A brain biopsy excluded cerebral vasculitis and tumoral processes. We discuss the differential diagnosis of status epilepticus in a patient with SLE. © 2012 Elsevier España, S.L. All rights reserved. Encefalitis con estatus convulsivo localizado en una paciente con lupus eritematoso sistémico
Factors at diagnosis predict subsequent occurrence of seizures in systemic lupus erythematosus
Neurology, 2005
Objective: To determine the factors associated with seizures in systemic lupus erythematosus (SLE).Methods: One hundred ninety-five patients with SLE were followed at the University of Maryland Lupus Clinics from January 1992 until June 2004. Neuropsychiatric (NP) manifestations were defined according to the American College of Rheumatology nomenclature and case definitions for NP-SLE syndromes, and seizures were defined using the International Classification of Epileptic Seizures. At the end of the study period, 28 of the 195 (14%) patients with SLE had seizures (21 generalized convulsive, 7 partial) during their course of disease. Recurrent seizures or epilepsy occurred in 12 of 28 patients (43%). The baseline features of those patients with seizures and those without them were compared to determine their contribution to the occurrence of isolated seizures and epilepsy.Results: Isolated seizures in SLE are common; epilepsy is less frequent but nonetheless important. Certain clinic...
Epileptic seizures and EEG features in juvenile systemic lupus erythematosus
Arquivos de Neuro-Psiquiatria, 2008
Introduction: Juvenile systemic lupus erythematosus is more incident in female affecting different systems including the central nervous system. The aim of this study was to check the incidence of seizures and electroencephalographic features in these patients. Method: It was analyzed all patients with juvenile systemic lupus erythematosus referred to the Pequeno Príncipe Hospital in Curitiba, PR, Brazil, in the year of 2007. The patients were submitted to EEG and subdivided into two groups according to the presence or absence of epileptic seizures. Mann-Whitney statistical test was used. Results: Forty-nine cases were included, there were 73.45% female, with an age between 3 and 28 years (m=17.00 years; s=5.01 years). Seizures (13/26.50%) were the most frequent manifestation followed by headache (13/26.50%) and ischemic stroke (6/12.25%). Cerebral vasculites were the most frequent alteration in neuroimage. The abnormalities of EEG were characterized by asymmetry of the electric cerebral activity, diffuse disorganized background activity, focal epileptiform discharges in the right central-temporal region, generalized paroxysmal of 3 Hz spike-waves, and bursts of theta-delta slowness activity in the right parietal-occiptal region. The statistic analysis showed no significantly difference between age of onset of symptoms and the risk of seizures (p 0.675) as well as between time of the disease and the risk of seizures (p 0.436). Conclusion: Neurologic manifestations, in special epileptic seizures, are frequent in systemic lupus erythematosus. Age of onset of symptoms and the time of disease did not increase the risk of epileptic seizures in this disease.
Electroencephalography in systemic lupus erythematosus patients with neuropsychiatric manifestations
The Egyptian Journal of Internal Medicine, 2020
Background Neuropsychiatric manifestations are frequently reported in systemic lupus erythematosus (SLE) patients. This study was done to describe electroencephalographic (EEG) findings in SLE patients with neuropsychiatric manifestation (NPSLE). Results Among 60 SLE patients, there were 50 females (83.3%) and 10 males (16.7%). EEG abnormalities were reported in 12 patients out of 30 (40%) with NPSLE, while all patients with non-NPSLE (n = 30) had no EEG abnormalities; diffuse slowing (20%) was the most common abnormalities, followed by generalized epileptiform activity (13.3%), and lastly temporal epileptiform activity (6.7%). Seizure was the most reported neuropsychiatric disorder in 13 patients (43.3%); 8 of them had abnormal EEG (61.5%). Periventricular white matter lesion (23.3%) followed by infarction (13.3%) were the most common MRI brain findings among 53.3% of NPSLE group. Half of the cases with EEG abnormality had normal brain MRI. SLEDAI score and ACL IgM positivity were ...
Profile of neurological manifestations in systemic lupus erythematosus
Indian Journal of Rheumatology, 2010
INTRODUCTION: To study the pattern of neurological involvement in systemic lupus erythematosus (SLE) and its correlation with investigation, disease activity and response to treatment. METHODS: This observational study was carried out from June 2007 to May ...
Epilepsy associated with systemic autoimmune disorders
2013
In Clinical Science Systemic Lupus Erythematosus (SLE) SLE involves central nervous system in 25% to 75% of cases (1). Seizure or psychosis is one of the 11 primary diagnostic criteria for SLE; they can occur around the time of disease onset (2). Seizures occur in 7% to 40% of SLE patients, with an average of ~15% (2-5). In SLE patients, generalized tonic-clonic seizures are most common (~75%), but simple and complex partial seizures can occur (6, 7). The first acute symptomatic seizure can occur either at (32%) or after (68%) SLE onset (2). After the initial seizure, 12% to 43% recur (2, 7), with most recurrences in the first year. Seizures are associated with increased morbidity and mortality in adults and children (3, 4). Status epilepticus may herald death (5); it should be aggressively treated and, if possible, the underlying cause identified. Seizures often occur during disease flares; the onset or worsening of seizure activity may reflect uremia, hypertension, CNS infection, stroke, or antiphospholipid antibodies (2). Hypertension may be associated with a posterior reversible encephalopathy syndrome characterized by altered mental status, headache, visual changes, seizures, and posterior leukoencephalopathy on imaging studies (8). Antiphospholipid antibodies are elevated in most studies of lupus patients with seizures or epilepsy, as well as those with stroke and headache (1, 9). Antiphospholipid antibodies are prothrombotic and can cause vascular disease, which can secondarily cause seizures. However, antiphospholipid antibodies are neuropathogenic in vitro, potentially causing seizures through direct neurotoxic effects (10). Other autoantibodies are also elevated in lupus patients with epilepsy (1, 11). To further complicate interpretation of antibody titers, some antiepileptic drugs can induce the lupus anticoagulant. To examine the role of IgG class anticardiolipin antibodies in an epilepsy (non-SLE) population, the frequencies of these antibodies were determined in a cohort of 960 epilepsy patients and 580 reference subjects; 4.5% of the epilepsy patients had elevated titers, similar to a control group (11). However,
A manifestation of systemic lupus erythematosus in the central nervous system
2015
Autoimmune limbic encephalitis (ALE) associated with systemic lupus erythematosus (SLE) is a rare entity with few reports in the literature to date. In general, ALE associated with SLE has a satisfactory response to immunosuppressive treatment (RIT), but the pathogenesis of this association is poorly understood and may include an autoimmunity component. We report a case study describing the diagnosis and management of limbic encephalitis in a patient with active Systemic Lupus Erythematosus disease (SLE) and past medical history of cancer (endometrial adenocarcinoma in 2004 and papillary urothelial carcinoma in 2011 with curative treatment), followed over a one-year period. We discuss the possible association between limbic encephalitis and all past neoplastic and immune-mediated conditions of this patient. In this particularly case, autoimmunity was the most relevant factor associated with limbic encephalitis given negative neoplastic screening. Moreover, a good response was observ...