Abstract
BackgroundNeuropsychiatric manifestations are frequently reported in systemic lupus erythematosus (SLE) patients. This study was done to describe electroencephalographic (EEG) findings in SLE patients with neuropsychiatric manifestation (NPSLE).ResultsAmong 60 SLE patients, there were 50 females (83.3%) and 10 males (16.7%). EEG abnormalities were reported in 12 patients out of 30 (40%) with NPSLE, while all patients with non-NPSLE (n = 30) had no EEG abnormalities; diffuse slowing (20%) was the most common abnormalities, followed by generalized epileptiform activity (13.3%), and lastly temporal epileptiform activity (6.7%). Seizure was the most reported neuropsychiatric disorder in 13 patients (43.3%); 8 of them had abnormal EEG (61.5%). Periventricular white matter lesion (23.3%) followed by infarction (13.3%) were the most common MRI brain findings among 53.3% of NPSLE group. Half of the cases with EEG abnormality had normal brain MRI. SLEDAI score and ACL IgM positivity were higher in the NPSLE group than the non-NPSLE group. EEG is not a sensitive or specific test for detecting NPSLE with sensitivity (37.5%) and specificity (57.1%).ConclusionNot all patients with NPSLE must have abnormal brain MRI or EEG. EEG is a useful assistant tool in the assessment of different manifestations of NPSLE, but it cannot be used as a screening test alone and must be supplemented by neuroimaging studies.
Highlights
Neuropsychiatric manifestations are frequently reported in systemic lupus erythematosus (SLE) patients
Based on the ACR criteria for neuropsychiatric manifestations [10], patients were classified into 2 groups: 30 patients with neuropsychiatric manifestations (NPSLE) as cases and 30 patients without neuropsychiatric manifestations as controls
Laboratory investigations including complete blood count (CBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), blood urea nitrogen (BUN), serum creatinine, urine analysis, protein/creatinine (P/C) ratio, complement C3, C4, lupus anticoagulant (LAC), and anticardiolipin (ACL) antibodies IgM and IgG and EEG were done for all participants at the neurology department, using Nihon Kohden LS-120 device
Summary
Neuropsychiatric manifestations are frequently reported in systemic lupus erythematosus (SLE) patients. This study was done to describe electroencephalographic (EEG) findings in SLE patients with neuropsychiatric manifestation (NPSLE). Nervous system involvement in SLE leads to a heterogeneous group of neurological and psychiatric (neuropsychiatric) symptoms. Any of these neuropsychiatric (NP) events can be directly attributed to SLE (NPSLE) or to an alternative etiology [4]. NPSLE is frequently reported in 75% of SLE patients and that varied from mild presentation like headache or mood disturbance to life-threatening conditions as with acute confusional state, major fits, stroke, or transverse myelitis [5]. The wide range of presentations and differential diagnosis often pose a difficult diagnostic challenge for clinicians [6]
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