Nervous System

Cognitive Dysfunction

At some point during the course of their lupus, up to 50 percent of lupus patients describe feelings of

confusion,
fatigue,
memory impairment, and
difficulty expressing their thoughts.

This collection of symptoms is called cognitive dysfunction and is found in people with mild to moderately active SLE. These symptoms may be clearly documented by neuropsychological testing, and a newer neurodiagnostic test called the single positron emission computed tomography (SPECT) scan shows reproducible blood flow abnormalities.

The reasons for these symptoms are not known. It may have something to do with changes in how a group of chemicals known as cytokines are handled or may be related to certain parts of the brain not getting enough oxygen.

Other tests including:

Spinal taps,

brain wave tests (EEG),

magnetic resonance imaging (MRI) or

computerized tomography (CT) scans of the brain may all be normal.

Cognitive dysfunction may come and go on its own, so the management of cognitive dysfunction is often frustrating and currently no optimal therapy is available.

Antimalarials and/or steroids may be useful.
Counseling, cognitive behavioral therapy and other interventions that assist a person in developing coping skills may be helpful.

Lupus Headache

People with lupus experience headaches which are unrelated to their lupus, i.e., sinus headache, tension headache and bone spurs from osteoarthritis. Approximately 20 percent of patients with SLE experience severe headaches which are related to the disease and known as lupus headache.

The lupus headache phenomenon is similar to migraine and may be seen more often in people who also have Raynaud's phenomenon.
SPECT scans indicate abnormalities in blood vessel tone or the ability of a vessel to dilate or constrict.
Lupus headache is treated like tension headaches or migraine, although corticosteroids are occasionally useful.

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