Nervous System Involvement
Lupus is an autoimmune disease that can affect almost any part
of your body, including your joints, skin, kidneys, heart, lungs, or blood.
Lupus can also affect the nervous system and brain. There are several terms
doctors use to describe this: neuropsychiatric lupus (NP-SLE), neurocognitive
dysfunction, or central nervous system lupus (CNS lupus). Your nervous system
has three parts, any of which may be affected by lupus.
when their nervous system is affected. The symptoms may come on suddenly or may
come and go, but they will vary depending upon the location and extent of the
tissue injury. These symptoms also can be present in other diseases, so
diagnosing lupus-related nervous system disorders is often
difficult.
Neurologists are the physicians who specialize in the nervous
system. They may rely on a number of diagnostic tools to determine whether
lupus is involved in your cognitive problems:
your memory or other mental abilities have been affected.
Depending on the symptoms, a variety of medications are
available to treat lupus-related nervous system disorders, including
non-steroidal anti-inflammatory drugs, antimalarials, and steroids. Your
response to treatment may be rapid or gradual over several months. For many
people with lupus, nervous system involvement is completely
reversible.
Central Nervous System (CNS)
When lupus affects your central nervous system, many symptoms
may occur, including:
similar to the symptoms of CNS lupus. If you have symptoms of CNS lupus you
should consult a neurologist who can determine which symptoms are side effects
of medication and which are due to lupus. The drugs most known for causing
symptoms like those of CNS lupus are:
A serious form of lupus called CNS vasculitis may occur when
there is inflammation of the blood vessels of the brain. Characterized by high
fevers, seizures, psychosis, and meningitis-like stiffness of the neck, CNS
vasculitis is the most dangerous form of lupus involving the nervous system and
usually requires hospitalization and high doses of corticosteroids to suppress
the inflammation.
Peripheral Nervous System (PNS)
The nerves of your peripheral nervous system control your
motor responses and sensation, so symptoms of numbness or tingling, or
inability to move a part of your body, may be the result of lupus affecting
these nerves. Known as peripheral neuropathies, symptoms of PNS nerve damage
are caused by inflammation of the nerves or by compression of the nerves due to
swelling in the tissue around them. The types of symptoms you might experience
include:
The autonomic nervous system regulates many of your body’s
functions that happen almost automatically: heart rate, blood pressure, feeling
hot or cold, bladder and bowel functions, release of adrenalin, breathing,
sweating, and muscle movement. Lupus can cause these nerve signals to be
overactive, which can lead to a wide range of symptoms:
Raynaud’s phenomenon
Raynaud’s phenomenon is a condition of ANS involvement caused
by inflammation of nerves or blood vessels. Blood vessels in your hands and
feet go into spasm and restrict blood flow, usually as a reaction to cold
temperatures, with the tips of the fingers or toes turning red, white, or blue.
Raynaud’s can also cause pain, numbness, or tingling in fingers and/or toes.
People who have Raynaud’s phenomenon are advised to avoid cold conditions when
possible, and may have to wear gloves or mittens when in air-conditioned
surroundings.
Livedo reticularis and palmar erythema are two other skin
disorders that may affect you if you have autonomic nerve damage. Both of these
conditions can cause a bluish, lacelike mottling under your skin, especially on
your legs, giving your skin a "fishnet" look.
Cognitive Dysfunction
As many as half of all people with lupus describe feelings of
confusion, fatigue, memory loss, and difficulty expressing their thoughts. This
collection of symptoms is termed cognitive dysfunction, although many people
call it "lupus fog."
Cognitive dysfunction most often affects people with mild to
moderately active lupus. The causes of these symptoms, and the reasons that the
symptoms tend to come and go, are not known. Living with cognitive dysfunction
can be very frustrating. However, you can learn to improve your concentration
and lessen confusion and memory loss with a variety of coping skills, including
puzzles, games, biofeedback, using a daily appointment calendar, and balancing
daily activities to reduce stress.
Lupus Headache
Compared with the general population, people with lupus may be
twice as likely to experience migraine-like lupus headaches, commonly known as
lupus headaches. The features of lupus headaches are similar to migraines and
may be seen more often in people who also have Raynaud’s phenomenon. However,
headaches can also be caused by vasculitis, a symptom of active lupus due to
inflammation of the blood vessels. If you are experiencing headaches that are
not improved by an over-the-counter headache medication, be sure to tell your
doctor.
This information comes from the Lupus Foundation of America.
of your body, including your joints, skin, kidneys, heart, lungs, or blood.
Lupus can also affect the nervous system and brain. There are several terms
doctors use to describe this: neuropsychiatric lupus (NP-SLE), neurocognitive
dysfunction, or central nervous system lupus (CNS lupus). Your nervous system
has three parts, any of which may be affected by lupus.
- The central nervous system (CNS) consists of the brain and the spinal cord.
- The peripheral nervous system (PNS) is a network of nerves that connects the
brain and spinal cord to the rest of the body, and gives skin and muscles the
signals needed for sensation and movement. - The autonomic nervous system (ANS) allows communication between spinal and
peripheral nerves and the brain and internal organs, and controls functions
like breathing, blood flow, and heart rate.
when their nervous system is affected. The symptoms may come on suddenly or may
come and go, but they will vary depending upon the location and extent of the
tissue injury. These symptoms also can be present in other diseases, so
diagnosing lupus-related nervous system disorders is often
difficult.
Neurologists are the physicians who specialize in the nervous
system. They may rely on a number of diagnostic tools to determine whether
lupus is involved in your cognitive problems:
- x-rays
- brain scans (magnetic resonance imaging (MRI) and computed tomography (CT)
- electroencephalograms (to capture the electrical pattern of brain activity)
- spinal tap (to examine fluid in the spinal column)
your memory or other mental abilities have been affected.
Depending on the symptoms, a variety of medications are
available to treat lupus-related nervous system disorders, including
non-steroidal anti-inflammatory drugs, antimalarials, and steroids. Your
response to treatment may be rapid or gradual over several months. For many
people with lupus, nervous system involvement is completely
reversible.
Central Nervous System (CNS)
When lupus affects your central nervous system, many symptoms
may occur, including:
- headaches
- confusion
- fatigue
- depression
- seizures
- strokes
- vision problems
- mood swings
- difficulty concentrating
similar to the symptoms of CNS lupus. If you have symptoms of CNS lupus you
should consult a neurologist who can determine which symptoms are side effects
of medication and which are due to lupus. The drugs most known for causing
symptoms like those of CNS lupus are:
- Non-steroidal anti-inflammatory drugs (NSAIDs) – may cause
headache, dizziness, confusion, and in rare instances, meningitis-like
symptoms - Antimalarials – in very high doses (not usually given for
lupus) may cause manic behavior, seizures, psychosis - Corticosteroids – may cause agitation, confusion, mood
swings, psychosis, depression - Anti-hypertensive medications – may cause depression or loss
of sex drive
A serious form of lupus called CNS vasculitis may occur when
there is inflammation of the blood vessels of the brain. Characterized by high
fevers, seizures, psychosis, and meningitis-like stiffness of the neck, CNS
vasculitis is the most dangerous form of lupus involving the nervous system and
usually requires hospitalization and high doses of corticosteroids to suppress
the inflammation.
Peripheral Nervous System (PNS)
The nerves of your peripheral nervous system control your
motor responses and sensation, so symptoms of numbness or tingling, or
inability to move a part of your body, may be the result of lupus affecting
these nerves. Known as peripheral neuropathies, symptoms of PNS nerve damage
are caused by inflammation of the nerves or by compression of the nerves due to
swelling in the tissue around them. The types of symptoms you might experience
include:
- vision problems
- facial pain
- ringing in the ears
- dizziness
- drooping of an eyelid
- carpel tunnel syndrome
The autonomic nervous system regulates many of your body’s
functions that happen almost automatically: heart rate, blood pressure, feeling
hot or cold, bladder and bowel functions, release of adrenalin, breathing,
sweating, and muscle movement. Lupus can cause these nerve signals to be
overactive, which can lead to a wide range of symptoms:
- numbness
- burning
- tingling
- mental confusion
- headaches
- gastrointestinal problems such as nausea, vomiting, constipation, or
diarrhea
Raynaud’s phenomenon
Raynaud’s phenomenon is a condition of ANS involvement caused
by inflammation of nerves or blood vessels. Blood vessels in your hands and
feet go into spasm and restrict blood flow, usually as a reaction to cold
temperatures, with the tips of the fingers or toes turning red, white, or blue.
Raynaud’s can also cause pain, numbness, or tingling in fingers and/or toes.
People who have Raynaud’s phenomenon are advised to avoid cold conditions when
possible, and may have to wear gloves or mittens when in air-conditioned
surroundings.
Livedo reticularis and palmar erythema are two other skin
disorders that may affect you if you have autonomic nerve damage. Both of these
conditions can cause a bluish, lacelike mottling under your skin, especially on
your legs, giving your skin a "fishnet" look.
Cognitive Dysfunction
As many as half of all people with lupus describe feelings of
confusion, fatigue, memory loss, and difficulty expressing their thoughts. This
collection of symptoms is termed cognitive dysfunction, although many people
call it "lupus fog."
Cognitive dysfunction most often affects people with mild to
moderately active lupus. The causes of these symptoms, and the reasons that the
symptoms tend to come and go, are not known. Living with cognitive dysfunction
can be very frustrating. However, you can learn to improve your concentration
and lessen confusion and memory loss with a variety of coping skills, including
puzzles, games, biofeedback, using a daily appointment calendar, and balancing
daily activities to reduce stress.
Lupus Headache
Compared with the general population, people with lupus may be
twice as likely to experience migraine-like lupus headaches, commonly known as
lupus headaches. The features of lupus headaches are similar to migraines and
may be seen more often in people who also have Raynaud’s phenomenon. However,
headaches can also be caused by vasculitis, a symptom of active lupus due to
inflammation of the blood vessels. If you are experiencing headaches that are
not improved by an over-the-counter headache medication, be sure to tell your
doctor.
This information comes from the Lupus Foundation of America.