Acute neurolupus manifested by seizures is associated with high frequency of abnormal cerebral blood flow velocities

Cerebrovasc Dis. 2008;25(4):348-54. doi: 10.1159/000118381. Epub 2008 Feb 27.

Abstract

Background: Systemic lupus erythematosus may present with a wide variety of neurological manifestations, which could be related to the presence of vasculopathy and microembolic signals (MES).

Objectives: We aimed to determine the prevalence of MES and altered blood flow velocities (BFVs) by transcranial Doppler (TCD) in patients with acute neuropsychiatric lupus erythematosus (NPLE).

Methods: Fifteen consecutive patients with acute NPLE (cases) and 30 patients with systemic lupus erythematosus but without acute NPLE (controls) underwent TCD testing for comparison purposes.

Results: We found higher mean BFVs in cases compared with controls in the left (100 vs. 73.5 cm/s, p = 0.018) and in the right (96 vs. 70 cm/s, p = 0.013) middle cerebral arteries. The proportion of MES in both groups was the same (13%). Abnormal TCDs were more frequent in patients with acute NPLE, 67 versus 17% (p = 0.001), and occurred more often in patients who presented seizures.

Conclusions: The frequency of MES was the same in both groups; however, patients with seizures due to acute NPLE usually present with higher BFVs than controls. This could be a marker of diffuse acute cerebral vasculopathy.

MeSH terms

  • Adolescent
  • Adult
  • Blood Flow Velocity / physiology
  • Case-Control Studies
  • Cerebrovascular Disorders / complications*
  • Cerebrovascular Disorders / physiopathology
  • Female
  • Humans
  • Intracranial Embolism / complications
  • Intracranial Embolism / diagnostic imaging
  • Intracranial Embolism / physiopathology
  • Lupus Erythematosus, Systemic / complications*
  • Lupus Erythematosus, Systemic / physiopathology
  • Male
  • Microcirculation / physiopathology
  • Middle Aged
  • Middle Cerebral Artery / diagnostic imaging
  • Middle Cerebral Artery / physiopathology*
  • Prevalence
  • Seizures / etiology*
  • Seizures / physiopathology
  • Ultrasonography, Doppler, Transcranial