A study on Neuropsychiatric Manifestations of Systemic Lupus Erythematosus.

Systemic lupus erythematosus (SLE) is the prototype of systemic autoimmune diseases. It affects predominantly women in their reproductive years. Remissions and relapses characterize the disease. The clinical manifestations and their severity in individual patients may vary considerably and, therefore, the treatment strategy needs to be tailored accordingly. Systemic lupus erythematosus (SLE) has frequent and potentially serious neuropsychiatric (NP) manifestations that are of importance in the management of the disease. Lack of a diagnostic gold standard and ambiguous terminology have hampered epidemiologic research in neuropsychiatric systemic lupus erythematosus (NPSLE). The reported prevalence of NPSLE varies widely, from 14% to 75%, because of inconsistent classifications and selected patient populations in tertiary referral centers. A nomenclature system recently developed by the American College of Rheumatology (ACR) is the first step toward standardized and internationally accepted classification of NPSLE. This nomenclature comprises case definitions including diagnostic criteria, exclusions, and methods of ascertainment for a total of 19 syndromes. The purpose of this cross-sectional, hospital based study is to assess the validity of the ACR nomenclature and case definitions for NPSLE. 1. Atleast one Neuropsychiatric SLE (NPSLE) syndrome was found in 70% of SLE patients admitted. 2. Females were more predominant (F:M=20:1) 3. 9.5% of patients presented with NPSLE as the first manifestation of SLE. 4. Headache was the most common presentation seen in 54.7% patients followed by mood disorders(depression) (47.6%). Migraine without aura was the most common type of headache noted. 5. Psychosis was seen only in 12% of patients. 6. Peripheral nerve disorders were seen in 12% of the patients. 7. Seizure disorder was seen in 33% of patients, generalized seizure being the most common among them. 8. Tremor disorder seen in 4.8% of the patients. 9. Some of the defined NPSLE syndromes like demyelinating diseases, aseptic meningitis, myelopathy, anxiety disorder, autonomic disorder, myasthenia, cranial neuropathy and plexopathy were not observed in the present study