A study of neurological manifestations in systemic lupus erythematosus A study of Neurological manifestations in systemic lupus erythematosus

To analyze clinical, immunological, electrophysiological and radiological spectrum of the patients of Systemic Lupus Erythematosus (SLE) presented with neurological manifestations in Gauhati Medical College & Hospital, Guwahati. Materials and methods: Hospital based prospective study carried out in Neurology department. Diagnosed cases of SLE who presented with neurological manifestations at the time of diagnosis or develop during the course of the disease were included in the study. Subjects undergone detailed clinical, immunological and laboratory analysis & appropriate statistical methods were applied as required. Results: A total number of 82 cases were evaluated. Median age of presentation was 22 years with female to male ratio 3.5:1. CNS diseases were predominant in 72(87.8%) and rests were symptoms referable to PNS. Among the CNS diseases most common was seizure in 28(38.9%) followed by acute confusional state, headache, myelopathy, stroke, psychosis. Among PNS diseases, most common was polyneuropathy in 12(63.2%), followed by cranial neuropathy, plexopathy, AIDP and myasthenia gravis. ANA was found to be the most common autoantibody in 81(98.7%) cases followed by Anti-ds DNA. Mean SLEDAI was 8.9 ± 5.7. Disease activity is significantly more in CNS as compared to PNS diseases. It was found that SLEDAI, values on 4-point liker scale and SLICC/ ACR damage index significantly decreased at 6 months during follow up. Conclusion: Neurological manifestations are not uncommon in SLE. They correlate with disease activity, and results in high morbidity if not diagnosed early. It is necessary to detect subclinical NPSLE by having a high index of suspicion, and evaluation by clinical, immunological, neuroimaging and neurophysiological tests.