The Diversity of Neurologic Events in Systemic Lupus Erythematosus: Prospective Clinical and Computed Tomographic Classification of 82 Events in 71 Patients

doi:10.1001/archneur.1986.00520030063016

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Vol. 43 No. 3, March 1986

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The Diversity of Neurologic Events in Systemic Lupus Erythematosus

Prospective Clinical and Computed Tomographic Classification of 82 Events in 71 Patients

Alan T. Kaell, MD; Mahadevan Shetty, MD; Benjamin C. P. Lee, MD; Michael D. Lockshin, MD

Arch Neurol. 1986;43(3):273-276.

Abstract

• To investigate outcome and pathophysiology of centralnervous system (CNS) systemic lupus erythematosus (SLE), weprospectively codified all cases of CNS SLE. Eighty-two eventsoccurred in 71 patients. Four events in four patients were dueto infection and were excluded. Twelve events occurred in 11women with positive antinuclear antibody but negative anti-DNAantibody test reactions and no other manifestation of SLE. Ofthe remaining 66 events (56 patients), 26 events were "isolated"and 40 "complex." Non-CNS SLE was "active" during 47 eventsand "inactive" during 19 events. "Isolated" CNS events wereequally likely in clinically "active" and "inactive" SLE. Patientswith active SLE were as likely to have an episodic or remittentcourse as were patients with inactive SLE. "Complex" events,however, were more likely to have favorable outcome than were"isolated" events. "Isolated" events without focal CT abnormalities,the only component of CNS SLE that can be called diffuse lupusencephalitis, accounted for only 20% of all neurologic events.

Author Affiliations

From the Division of Rheumatic Diseases, Hospital for Special Surgery (Drs Kaell and Lockshin), and the Division of Neuroradiology (Drs Shetty and Lee), The New York Hospital-Cornell University Medical College New York.

Footnotes

Accepted for publication July 22, 1985.

Reprint requests to Hospital for Special Surgery, 535 E 70thSt, New York, NY 10021 (Dr Lockshin).

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