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Learn about 9 neurological symptoms of lupus and how to manage them
Lupus can affect both types of the nervous system—the central nervous system (CNS) and the peripheral nervous system (PNS)—through antibodies that bind to the nerve cells, by attacking the blood vessels that feed them, or interrupting the blood flow to the nerves.
When lupus attacks the nervous system, it can lead to cognitive dysfunction and other neurological symptoms. Learn about 9 neurological symptoms of lupus and how to manage them.
9 neurological symptoms of lupus
1. Cognitive dysfunction
Cognitive dysfunction is the most common neurological symptom of neurolupus, affecting 80% of people with systemic lupus erythematosus (SLE). Signs may include:
- Cloudy (unclear) thinking
- Confusion
- Impaired memory
Causes of cognitive dysfunction may be abnormalities in blood flow that lead to decreased oxygen delivery to certain parts of the brain.
Usually, cognitive dysfunction doesn’t worsen over time, and there is no real treatment for treating the symptoms. Therapies that may help include cognitive therapy and counseling.
2. Headache
Some people with SLE may experience migraine-like headaches. These headaches are different from lupus headaches caused by active lupus that requires a lumbar puncture or blood vessel study.
Treatment may include the following:
- Migraine prevention diet may be recommended.
- Nortriptyline can be used to reduce headache frequency and severity when diet alone is insufficient.
- Corticosteroids are usually recommended for true lupus headaches.
3. Fibromyalgia
Most people with lupus have fibromyalgia, and most of the pain people feel is due to fibromyalgia. Fibromyalgia is a chronic pain sensitization disorder characterized by widespread:
The exact cause of fibromyalgia is unknown. However, it is believed to occur due to the rewiring of pain pathways that lead to the spinal cord and brain. As a result, the CNS experiences an enhanced sensitivity to pain signals.
To check for fibromyalgia, your doctor may touch several points on the muscles of your body. People with fibromyalgia often feel pain with light pressure applied to these sites.
Drugs approved for the treatment of fibromyalgia include:
Other ways to manage fibromyalgia symptoms include regular exercise, frequent rest times, and managing stress.
4. Organic brain syndrome
Organic brain syndrome is a condition that leads to impaired brain function, likely due to brain edema secondary to autoimmunity. Some other names for this syndrome include cerebritis, encephalopathy, and acute confusional state.
This condition is usually diagnosed with the help of lumbar puncture and electroencephalography. Before confirming a diagnosis, the following conditions may be ruled out:
If lupus is the cause of organic brain syndrome, high-dose steroids may be recommended to combat the effects.
5. CNS vasculitis
CNS vasculitis is a rare complication of lupus that involves inflammation of blood vessels in the brain. Magnetic resonance angiography or computed tomography angiography of the brain can detect the presence of vasculitis. Treatment of CNS vasculitis involves the use of high-dose steroids.
6. Seizures
Seizures occur in 14%-25% of people with lupus. Some of the reasons for seizures associated with SLE include:
- Inflammation of blood vessels in the brain
- Clot formation
- Infections
- Side effects of SLE drugs
Damage to the brain caused by lupus can lead to uncontrollable muscle movements, loss of consciousness, and periods of confusion. Steroids or anticonvulsant medications may be recommended to treat seizures.
7. Transverse myelitis
Myelitis refers to the inflammation of the spinal cord and occurs in 1% of people with lupus. Some of the symptoms include:
- Numbness
- Tingling
- Loss of sensation
- Pain
- Weakness
- Loss of bowel and bladder control
- Paraplegia or inability to move the limbs
Treatment options for myelitis include:
- High dose prednisone
- Cyclophosphamide
- Anticoagulants
8. Stroke
People with neuropsychiatric lupus are at a high risk of a stroke. The presence of antiphospholipid antibodies may increase the risk of a stroke. Treatment options include:
9. Peripheral neuropathies
Peripheral neuropathies occur in about 18% of people with lupus due to nerve damage or inflammation. Common symptoms include:
- Severe pain
- Weakness
- Numbness
- Pins-and-needles sensation
Treatment options for neuropathy include:
- Corticosteroids
- Other immunosuppressive drugs
What complications are associated with lupus treatment?
Treatment with corticosteroids and other systemic lupus erythematosus drugs can lead to certain complications including:
- Reversible posterior leukoencephalopathy syndrome, which is characterized by the brain-capillary leak, characterized by symptoms of headache, visual loss, seizures, and altered mental functioning
- Serious infections of the central nervous system such as encephalitis
- Mood disorders
- Memory impairment
How can you manage neurological symptoms of lupus?
Tips to manage neurological symptoms of lupus may include:
- Adopting healthy lifestyle habits such as eating a nutritious diet and getting quality sleep
- Light stretching activities such as tai chi and yoga to relax muscles and prevent pain associated with fibromyalgia
- Engaging in moderate to heavy intensity exercises for at least 30 minutes a day, which can improve mood
- Reducing stress
- Finding supportive social networks
