Electroencephalographic Findings in a Cohort of Egyptian Systemic Lupus Erythematosus Patients with Neuropsychiatric Manifestations

Abstract

LE is a prototypic autoimmune disease characterized by production of autoantibodies against cell nucleus giving rise to diverse clinical manifestations that almost affect all organ systems. Central nervous system involvement in SLE is characteristic of severe disease as it drives most of SLE disease morbidity and mortality. It leads to a heterogeneous group of neurological and psychiatric (neuropsychiatric) symptoms. Any of these neuropsychiatric (NP) events can be directly attributed to SLE (NP SLE) or to an alternative etiology (non-NP SLE). NP SLE is frequently reported in 75% of SLE patients and that varied from mild subtle signs: headache or mood disturbance to life threatening conditions: acute confusional state, major fits, stroke or transverse myelitis. The wide range of presentations and differential diagnosis often pose a difficult diagnostic challenge for clinicians. Routine and quantitative EEG was used to determine whether there is a lateralized pattern of electrophysiologic dysfunction in SLE patients with diverse neuropsychiatric manifestations or not. Epileptiform discharges were observed in some SLE patients. These EEG abnormalities were mostly observed in patients with clinical NPSLE and that abnormal EEG may be an indicator for subclinical NPSLE.