Online ISSN : 1687-8329


Quick Search 

October2013 Vol.50 Issue:        4        Table of Contents
Full Text

Neuropsychiatric Manifestations in Clinically Silent Patients with Systemic Lupus Erythematosus

Enas Mahmoud Hasen1, Hana Ahmed Sadek2, Salwa Mohamed Rabee3, Lamia Hamdy4

Departments of Neurology1, Rheumatology2, Psychiatry3, Clinical Pathology4, Minia University; Egypt


Background: The diagnosis of neuropsychiatric syndromes concurrent with systemic lupus erythematosus (SLE) is one of the most difficult challenges in medicine. Objective: The study aimed to determine the neuropsychiatric (NP) manifestations in clinically silent SLE patients and to study the effectiveness of cognitive evoked potential studies in assessment. Methods: Twenty-five SLE patients were evaluated for NP manifestations and compared with 15 healthy controls. The patients were subjected to neuropsychiatric examinations: laboratory, Mini-Mental State Examination (MMSE), Hamilton Depression Scale, and Hamilton Anxiety Scale as well as disease activity markers and neurophysiology; nerve conduction study (NCS) and P300 evoked potential. Results: The most prevalent NP manifestations were headache and depression 17 patients (68%), epileptic symptoms in 15 cases (60%), peripheral neuropathy signs in 12 patients (48%) and anxiety in 10 patients (40%). Abnormal EEG findings were observed in 11 cases (44%). The MMSE showed cognitive impairment in 9 patients (36%). There was sensorimotor neuropathy in SLE patients and positively correlated with markers of disease activity. Prolonged P300 latency was found in one SLE patient with negative correlation with disease activity markers. Conclusion: The presence of subclinical neuropsychiatric affection even in asymptomatic patients should be investigated. Its early management may affect quality of life or even the disease process itself. P300 wave reflects the cognitive level of SLE, which is more objective than MMSE score and may be a valuable and noninvasive new index for evaluating the level of cognitive function in SLE patients. [Egypt J Neurol Psychiat Neurosurg.  2013; 50(4): 403-409]

 Key Words: SLE, SLEDAI, SLAM, cognitive function, depression, anxiety, neurological disorders.

 Correspondence to Enas Mahmoud Hasen.Department of Neurology, Minia University, Egypt. Tel.: +201224477931    e-mail: enas_mahmoud1 @yahoo .com. 

2008 � Copyright The Egyptian Journal of Neurology,
Psychiatry and Neurosurgery. All rights reserved.

Powered By DOT IT