Abstract
Systemic lupus erythematosus (SLE) is a multisystem, autoimmune connective tissue disorder. Neuropsychiatric SLE (NPSLE) has varied clinical and radiological manifestations. Clinical manifestations range from subtle abnormalities of neurocognitive functions and mood changes to overt psychiatric or neurological manifestations such as seizures, stroke, and psychosis. Magnetic resonance imaging (MRI) may show various types of abnormalities. Cerebral white matter lesions are most common (60–86%). Here, we are discussing a young female who presented with alteration of sensorium and right-sided hemiparesis, and MRI of the brain showed extensive involvement of brainstem in the form of possible demyelination.
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References
American College of Rheumatology (1999) Nomenclature and case definitions for neuropsychiatric lupus syndromes. Arthritis Rheum 42:599–608
Mok CC, To CH, Mak A (2006) Neuropsychiatric damage in southern Chinese patients with systemic lupus erythematosus. Medicine (Baltimore) 85:221–228
Sibbitt WL, Sibbitt RR, Brooks WM (1999) Neuroimaging in neuropsychiatric systemic lupus erythematosus. Arthritis Rheum 42:2026–2038
Lalani TA, Kanne JP, Hatfield GA et al (2004) Imaging findings in systemic lupus erythematosus. Radiographics 24:1069–1086
Jennings JE, Sundgren PC, Attwood J et al (2004) Value of MRI of the brain in patients with systemic lupus erythematosus and neurologic disturbance. Neuroradiology 46:15–21
Sailer M, Burchert W, Ehrenheim C et al (1997) Positron emission tomography and magnetic resonance imaging for cerebral involvement in patients with systemic lupus erythematosus. J Neurol 244:186–193
Sabet A, Sibbitt WL Jr, Stidley CA et al (1998) Neurometabolite markers of cerebral injury in the antiphospholipid antibody syndrome of systemic lupus erythematosus. Stroke 29:2254–2260
Provenzale JM, Barboriak DP, Allen NB et al (1996) Patients with antiphospholipid antibodies: CT and MR findings of the brain. AJR Am J Roentgenol 167:1573–1578
Ishikawa O, Ohnishi K, Miyachi Y et al (1994) Cerebral lesions in systemic lupus erythematosus detected by magnetic resonance imaging: relationship to anticardiolipin antibody. J Rheumatol 21:87–90
Trevisani VF et al (2000) Cyclophosphamide versus methylprednisolone for the treatment of neuropsychiatric involvement in systemic lupus erythematosus (Cochrane review). Cochrane Database Syst Rev 3:CD00265
Leung FK, Fortin PR (2003) Intravenous cyclophosphamide and high dose corticosteroids improve MRI lesions in demyelinating syndrome in systemic lupus erythematosus. J Rheumatol 30:1871–1873
Khamashta MA, Cuadrado MJ, Mujic F et al (1995) The management of thrombosis in the antiphospholipid-antibody syndrome. N Engl J Med 332:993–997
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Kumar, S., Sharma, N., Sharma, A. et al. A case of systemic lupus erythematosus with extensive brain stem involvement. Clin Rheumatol 28 (Suppl 1), 69–71 (2009). https://doi.org/10.1007/s10067-009-1171-6
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DOI: https://doi.org/10.1007/s10067-009-1171-6