Brain symptoms are the least acknowledged and most misunderstood symptoms of lupus. Yet 50% of patients experience some sort of brain symptoms in the course of their disease. If your brain is affected by lupus, you may experience headaches, dizziness, behavior changes, vision problems, and even strokes or seizures. Many people with lupus experience memory problems and may have difficulty expressing their thoughts. People with lupus who have neurological symptoms might find themselves disbelieved or, at best, believed but not helped.
Symptoms of Lupus in the Brain
Many studies have shown that about half of patients with lupus develop brain involvement. For example 37% of the patients studied during 1970-1975 and 52 percent of the patients studied during 1970-1975 and 52 percent of patients evaluated from 1980-1984 experienced nervous system disease caused by lupus. Although central nervous system disease can develop at anytime, the most frequent time of onset is in the first year of systemic lupus. Patients who do not have central nervous disease in the first year or two are less likely to ever develop brain disease. Brain based symptoms of lupus can be complicated to diagnose, are often subtle and can be easily ignored. Some of the most notable symptoms of lupus in the brain include…
- Frequent Headaches
- Migraines and dizzy Spells
- Seizures and Fits
- Memory Loss or Lapses
- Vision Problems such as Blurriness or Vision Loss
- Sudden and Unexplained Mood and Behavior Changes
- Fatigue and Brain Fog
- Depression and Anxiety
Brain Fog and Lupus
The term brain fog is a term that many people with lupus use to explain their symptoms of concentration, memory, and thinking. It is called fog because it is like the brain is clogged with a thick fog and trying to move through a thick blanket. It often takes extra effort to understand something and it is very frustrating symptom. It often takes extra effort to understand something or get a task done. Brain fog is often misunderstood and it can flare up like any other lupus symptom. It can also be caused by fatigue, pain, and improper nutrition. Also the worry and pain of lupus can cause sleep deprivation which can trigger the brain fog.
How Does Lupus Attack the Brain?
Scientist currently believe lupus attacks the brain through two different ways…
Through the Blood-Brain Barrier
Experts have previously postulated a linkage between lupus associated vascular pathology and abnormal brain barriers in the immunopathogenesis of neuropsychiatric lupus. Lupus disrupts the membrane that separates the blood supply of the brain from the delicate nervous system tissue of the brain itself. This barrier, called the blood-brain barrier, blocks hormones, chemicals, and other materials including immune system. Particles such as antibodies in the blood stream affect the brain.
Through the Bloodstream
Lupus can increase the risk of strokes and heart attacks. Additionally, it can interfere with proper blood flow by damaging blood vessels and causing rigid vessel walls, narrowing, and clots. Medication used for lupus can cause side effects that are similar to the symptoms of CNS lupus. It is very important to make sure that the medication is not the issue. 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
- Antimalarial – Very high doses (not usually given for lupus) may cause manic behavior, seizures, and psychosis
- Corticosteroids – May cause agitation, confusion, mood swings, psychosis, and depression
- Anti-Hypertensive Medications – May cause depression or loss of sex drive
Diagnosing Brain Symptoms of Lupus
Tests that are often used to help diagnosis of neuropsychiatric lupus may include spinal tap to remove fluid for analysis, electroencephalogram (EEG) to diagnose seizures, nerve conduction studies in case of nephropathy, and MRI to image the brain or spinal cord. Lupus symptoms are not actually brain damage and so cannot be easily seen on an MRI. A spinal tap, can detest major potential issues that would show up in the cerebrospinal fluid. Most lupus caused symptoms would not show up in such a test. The EEG are effective at detecting lupus-related brain symptoms as they detect changes in brain activity. But these methods can find other issues that could be mistaken for lupus. Other problems such as infections, brain hemorrhage, cancer and conditions such as MS and Guillain-Barre can be detected so these important tools in a lupus warrior arsenal of test need to be done.
Neuropsychiatric SLE is a serious complication of lupus that requires prompt attention and treatment. Good communication of the patient and doctor is very important for early diagnosis of the problem and effective treatment. The rheumatologist usually works together with a neurologist for the best care for these patients. When patients are treated this way, the results are often very good and rewarding to both patients and doctors. As with many other symptoms of lupus, taking care of your body with proper sleep, nutrition, exercise, and hydration can help bring down the symptoms greatly.
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The Cincinnati Rheumatic Disease Study Group (CRDSG) is an organization of practicing rheumatologists dedicated to improving the care of patients with arthritis and other rheumatic diseases. It strives to do this by performing rigorous and ethical clinical research with the goal of developing better treatments for all patients with these conditions.
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