CNS Lupus Questions & Answers

Updated: Jul 16, 2018
  • Author: Tarakad S Ramachandran, MBBS, MBA, MPH, FAAN, FACP, FAHA, FRCP, FRCPC, FRS, LRCP, MRCP, MRCS; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM  more...
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Questions & Answers

Overview

What is CNS lupus?

What is the pathophysiology of systemic lupus erythematosus (SLE), in relation to CNS lupus?

What are the etiologies of systemic lupus erythematosus (SLE), in relation to CNS lupus?

How does drug-induced myopathy lead to the development of CNS lupus?

How do amphiphilic drug myopathies lead to the development of CNS lupus?

What is the epidemiology of CNS lupus?

What is the prognosis of CNS lupus?

Presentation

What are the most common presenting symptoms CNS lupus?

Which mental status changes are associated with CNS lupus?

How is posterior reversible encephalopathy syndrome (PRES) distinguished from other CNS complications of systemic lupus erythematosus (SLE)?

How do seizures manifest in patients with CNS lupus?

What are the signs and symptoms of cranial nerve involvement in CNS lupus?

How is stroke characterized in CNS lupus?

How common is peripheral neuropathy in CNS lupus?

How is medication-induced myopathy distinguished from SLE-induced myopathy in CNS lupus?

How is spinal cord involvement characterized in CNS lupus?

How is fatigue characterized in patients with CNS lupus?

What are other neurologic syndromes associated with CNS lupus?

When should SLE/CNS lupus be considered in patients presenting with neurologic symptoms?

What are the physical exam findings in patients with CNS lupus?

DDX

What are the diagnostic considerations in CNS lupus?

Workup

What are the approach considerations in the diagnosis of CNS lupus?

What is the role of serum chemistry studies in the workup of CNS lupus?

What is the role of hepatocellular and muscle enzyme studies in the workup of CNS lupus?

What is the role of an antinuclear antibody test in the workup of CNS lupus?

What is the role of antiphospholipid antibodies testing in the workup of CNS lupus?

What is the role of lupus anticoagulant testing in the workup of CNS lupus?

What is the role of cerebrospinal fluid (CSF) analysis in the workup of CNS lupus?

When is a presumptive diagnosis of CNS lupus indicated?

What is the role of CT and MRI studies in the workup of CNS lupus?

How is CNS lupus distinguished from multiple sclerosis and other vasculitides on MRI?

What is the role of combination SPECT scanning and MRI in the workup of CNS lupus?

What is the role of PET scanning and magnetic resonance spectroscopy (MRS) in the workup of CNS lupus?

What is the role of magnetic resonance angiography (MRA) in the workup of CNS lupus?

When are spinal imaging studies indicated in the workup of CNS lupus?

What is the role of echocardiography and ultrasonography in the workup of CNS lupus?

What is the role of EEG in the workup of CNS lupus?

What is the role of EMG and nerve conduction studies in the workup of CNS lupus?

What is the role of biopsy in the workup of CNS lupus?

What is the role of nerve biopsy in the workup of CNS lupus?

What is the role of muscle biopsy in the workup of CNS lupus?

What is the role of brain biopsy in the workup of CNS lupus?

Treatment

What are the approach considerations for the treatment of CNS lupus?

What is the role of corticosteroids in the treatment of CNS lupus?

What is the role of antimalarial agents in the treatment of CNS lupus?

What is the role of cytotoxic agents in the treatment of CNS lupus?

Which drugs are being investigated for the treatment of CNS lupus?

What is the treatment for Devic syndrome associated with CNS lupus?

What is the treatment for myopathy or polyneuropathy associated with CNS lupus?

What is the treatment for polyradiculopathy associated with CNS lupus?

What is the treatment for seizures associated with CNS lupus?

What is the treatment for antiphospholipid syndrome (APLS) associated with CNS lupus?

Which specialist consultations are indicated in the treatment of CNS lupus?

What is the role of specialists in the long-term monitoring of CNS lupus?

Medications

What are the goals of drug treatment for CNS lupus?

Which medications in the drug class Electrolytes are used in the treatment of CNS Lupus?

Which medications in the drug class Tricyclic Antidepressants are used in the treatment of CNS Lupus?

Which medications in the drug class Anticonvulsants are used in the treatment of CNS Lupus?

Which medications in the drug class Nonsteroidal Anti-inflammatory Drugs (NSAIDs) are used in the treatment of CNS Lupus?

Which medications in the drug class Immune Globulins are used in the treatment of CNS Lupus?

Which medications in the drug class Antimalarials are used in the treatment of CNS Lupus?

Which medications in the drug class Immunosuppressants are used in the treatment of CNS Lupus?

Which medications in the drug class Corticosteroids are used in the treatment of CNS Lupus?