Sibley J T, Olszynski W P, Decoteau W E, Sundaram M B
Department of Medicine, University of Saskatchewan, Saskatoon, Canada.
J Rheumatol. 1992 Jan;19(1):47-52.
In a review of our experience with systemic lupus erythematosus (SLE) since 1975, we found 48 of 266 patients with major central nervous system (CNS) manifestations for which a non-SLE explanation could not be identified. Eleven patients developed more than one type of CNS event. The commonest symptom was seizure (18 patients), followed by brainstem dysfunction (12 patients), psychosis (11 patients), organic brain syndrome (11 patients) and stroke (7 patients). In 19% of cases, CNS manifestations were accompanied by a flare of multisystem SLE disease activity. Anticonvulsants were able to be discontinued safely in the majority of patients with seizures. Most CNS events were self-limited, reversible and not associated with poor outcome unless accompanied by multisystem disease activity. Therapy with corticosteroids did not appear to offer substantial benefit.
在回顾我们自1975年以来系统性红斑狼疮（SLE）的诊疗经验时，我们发现266例患者中有48例出现主要中枢神经系统（CNS）表现，且无法找到非SLE的解释。11例患者发生了不止一种类型的CNS事件。最常见的症状是癫痫发作（18例患者），其次是脑干功能障碍（12例患者）、精神病（11例患者）、器质性脑综合征（11例患者）和中风（7例患者）。在19%的病例中，CNS表现伴有多系统SLE疾病活动的发作。大多数癫痫发作患者能够安全停用抗惊厥药。大多数CNS事件是自限性、可逆的，且除非伴有多系统疾病活动，否则与不良预后无关。皮质类固醇治疗似乎没有带来实质性益处。
