Lupus Cerebritis

Dealing with Lupus Cerebritis

Lupus Cerebritis causes nervous system involvement in SLE cases in about twenty-five to fifty percent of American patients, during some part of their illness. This type of lupus is associated with chorea, stroke, seizures and headaches, as part of the array of disorders of the nervous system that SLE patients sometimes develop. Additionally, it is one of the hardest effects of lupus to diagnose.

With leaps forward in modern medicine, you can sometimes now get a specific diagnosis of lupus cerebritis earlier. Management of the manifestations in the nervous system is still not satisfactory. The best course of treatment is a subject open to debate. Newer therapies sometimes work for some health care professionals, but the evidence is only anecdotal.

Systemic lupus erythematosus (SLE) is an inflammatory, chronic disease of the tissues that connect our body parts. SLE can occur in any person of any race, age and gender, but the highest incidence is in women between thirteen and forty years old. To receive a diagnosis of SLE, the victim must have four or more of these organs involved: spinal cord and brain, hematologic system, joints, skin, cardiac or renal.

Because SLE involves so many systems, physicians may first see an SLE patient because of some problem with their central nervous system. Fifty percent or more of Americans with SLE suffer also from neurological involvement. There are various theories as to why some SLE patients have the central nervous system conditions, and this makes that aspect of SLE more difficult to diagnose.

There is controversy with regards to the best treatment approach for lupus cerebritis. Neurological physicians can be faced with a patient suffering from cerebral lupus, and that patient wants a diagnosis, but also wants to be treated with positive results.

The research into CNS involvement in SLE patients is mostly based on work with lab mice, and also on some study of human brains, post-mortem. The precise process of the disease is not known. Some theories as to why the central nervous system is involved include:

Release of cytokine

Antiphospholipid antibodies

Anti-neural antibodies

Immune complexes

No one of these mechanisms appears to be the direct cause of lupus cerebritis. In various cases, all of these mechanisms may act independently, and all may be present at once.

This type of lupus can present as a stroke, myelopathy, psychosis or seizures in patients with SLE. The neurological issue can be an isolated event or it can occur in association with other SLE signs. It may occur in children as well as adults, and the duration can last for as little as a few minutes, like a migraine, or as long as years, as is the case with dementia. There is still much to be learned about lupus cerebritis.