Demystifying neuropsychiatric lupus--is it possible?

The occurrence of nervous system events in patients with systemic lupus erythematosus (SLE) remains a diagnostic and therapeutic challenge due to the diversity of clinical manifestations, the correction attribution of events to SLE or other causes, and the lack of clinical trial data to facilitate the selection of treatment options. Over the past decade the classifcation and attribution of neuropsychiatric (NP) events has received more rigorous attention and new insights into the pathogenetic mechanisms have emerged through neuroimaging studies and elucidation of autoimmune and infammatory mechanisms. Although much work remains to be done on this complex and fascinating aspect of lupus, there is an emerging consensus on the pathogenesis and treatment of NP-SLE.