Studies have revealed that systemic lupus erythematosus may affect the nervous system. Lupus patients may experience confusion, difficulty concentrating, headaches, fatigue, strokes, or other signs of nervous system compromise.

Studies suggest that nerve tissue can be damaged when antibodies attack nerve cells or blood vessels. It is known that the nervous system requires an uninterrupted flow of blood, which is necessary to supply oxygen and nutrients to its tissues. When this blood flow is slowed or interrupted, nerve cells cannot function normally and symptoms appear. Symptoms vary, depending on where the tissue injury is located. It’s good to know that the nervous system has three parts. The central nervous system comprises the brain and spinal cord, the nerve fibers of the peripheral nervous system that have the function of providing the skin and muscles with the power necessary for sensation and movement, and the third part is the autonomic nervous system It has the function of regulating spinal, peripheral nerves and innervating internal organs.

An inflammation of the blood vessels in the brain that occurs in 10% of all lupus patients is called central nervous system vasculitis. This disease usually requires hospitalization and high doses of corticosteroids. Some of the symptoms that appear are high fever, seizures, psychosis and stiff neck similar to meningitis. If not treated aggressively, central nervous system vasculitis rapidly progresses to stupor and coma.

People with mild to moderate systemic lupus erythematosus may experience cognitive dysfunction. That is a group of symptoms that appear in about 50% of these patients, and we can mention here fatigue, memory impairment, feelings of confusion and difficulty in expressing thoughts. By taking a neuropsychological test or a test called positron emission tomography, these symptoms can be clearly documented. It is known that cognitive dysfunction can come and go on its own, but there is no optimal therapy available. In addition, it is not known what is the reason for the symptoms that appear. Dealing with cognitive dysfunction is frustrating, and counseling a person in developing coping skills can often be helpful.

About 20% of patients who have systemic lupus erythematosus experience a lupus headache. This is manifested by severe headaches, is similar to a migraine, and can often be seen in people who also have Raynaud’s phenomenon. As a treatment, the same one that is used in tension or migraine headaches is useful, and sometimes corticosteroids.

It is known that about a third of lupus patients may have a false-positive syphilis test, a positive anticardiolipin antibody, or a prolonged clotting time test. This is known as lupus anticoagulant or antiphospholipid antibody. About 1/9 of patients who have lupus will develop blood clots in various parts of the body, which is called antiphospholipid syndrome. If blood clots appear in the nervous system, they can cause a stroke, and symptoms of a stroke include painless pain. occurrence of neurological deficits without any signs of active lupus. If a stroke occurs, anticoagulant medications should be taken. We can mention here low-dose aspirin, coumadin or heparin.

Among patients who have systemic lupus erythematosus there is a percentage of 20% who also have fibromyalgia syndrome. These patients experience increased soft tissue pain, tender points, and in addition cognitive dysfunction, decreased ability to concentrate, lack of energy, and difficulty sleeping. As treatment, we can mention antidepressants, counseling and physical therapy if necessary.

It was found that drugs used to treat systemic lupus erythematosus can develop symptoms like those of central nervous system lupus, antimalarial psychosis can occur at very high doses; Headache, dizziness, and, rarely, meningitis-like symptoms may be caused by nonsteroidal anti-inflammatory drugs. Also if a patient uses corticosteroids, mood swings, psychosis, depression, agitation, confusion may occur, if high doses are taken seizures may occur, and antihypertensive medications may be associated with depression or loss of libido.

One study found that people who have lupus and Sjogren’s syndrome may be predisposed to developing vasculitis or cognitive dysfunction. Sometimes circulating proteins in the blood can cause cryoglobulinemia or hyperviscosity syndrome. Plasmapheresis or blood filtering can relieve these complications. Sometimes sharp decreases in platelet counts can be associated with bleeding. C can clot, and people with lupus, idiopathic thrombocytopenic purpura, and kidney failure can bleed.

In peripheral nervous system lupus, cranial nerve involvement can cause visual disturbances, drooping eyelids, ringing in the ears, facial pain, and dizziness. There is an inflammation of the blood vessels that supply the peripheral nerves. Symptoms may also occur due to conditions other than lupus, and electromyogram and nerve conduction tests are often helpful in determining if symptoms are due to some other cause. Corticosteroids are used to treat inflammation of the peripheral nerves.

It is important for your doctor to know if you are experiencing nervous system symptoms. These symptoms may be caused by lupus, a medication, or a particular aspect of your life. The doctor will ask about the symptoms you are experiencing, perform a physical exam, and perform a laboratory evaluation that includes a blood chemistry panel, complete blood count, and urinalysis. In addition, diagnostic tests such as erythrocyte sedimentation rate, ANA, anti-DNA, anti-P ribosomal antibodies, and complement may be helpful in determining nervous system involvement. Lumbar punctures. In some hospitals, PET scans may also be performed. Cerebrospinal fluid may be examined for cells, protein components, and antineuronal antibodies. In patients with cognitive dysfunction, neuropsychological testing may be helpful.

Treatment for nervous system lupus depends on its origin and may include immunosuppressants, blood thinners, antibiotics, steroids, antidepressants, counseling, or surgery. If there are obvious diagnostic difficulties, a rheumatologist and/or neurologist should be involved in your care. It has been found that for many people with lupus, the nervous system involvement is completely reversible.