Conclusions
- Both clinical and imaging manifestations of brain damage are
commonly seen in SLE.
- In SLE patients with sudden presentation of seizures, obtundation,
or other neurologic conditions, consider especially the possibility
of infarct or hypertensive encephalopathy. MRI can be especially
helpful in establishing these two diagnoses. The term "lupus
cerebritis" is very non-specific; more precise descriptions should
be used whenever possible.
- NPSLE syndromes have recently been classified by the American
College of Rheumatology, and this nosology should be used for
future research.
- The pathological basis of neuropsychiatric symptoms is still
uncertain. Possibilities include microinfarcts, antibodies to brain
tissue, circulating factors such as cytokines, and secondary
factors such as medication. True cerebral vasculitis is rare in
SLE.
- Chronic, diffuse changes occur in the brain in SLE. These may be
demonstrated by special techniques such as MRS. Research is
continuing on the use of these special techniques.
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