University of São Paulo, São Paulo, Brazil.
Eur J Clin Invest. 2010 Apr;40(4):350-9. doi: 10.1111/j.1365-2362.2010.02263.x. Epub 2010 Feb 19.
Neurologic disorders are among the most common and important clinical manifestations associated with the antiphospholipid syndrome (APS). It is characterized by diverse neurological manifestations. These include stroke, transient ischaemic attack, Sneddon's syndrome, convulsions/epilepsy, dementia, cognitive deficits, headaches/migraine, chorea, multiple sclerosis-like, transverse myelitis, ocular symptoms and Guillain-Barré syndrome.
We review the latest data about neurologic disorders and APS.
In patients under 45 years of age, 20% of strokes are potentially associated with APS. Our study group recently reported a correlation between primary APS and peripheral neuropathy. Only one study investigated the occurrence of peripheral neuropathy in patients diagnosed with PAPS through electrophysiological study and showed alterations in 35% of patients. The mechanism of nervous system involvement in APS is considered to be primarily thrombotic. However, other mechanisms have been described, such as antiphospholipid antibodies that bind to the neural tissue, deregulating their functions and having an immediate pathogenic effect.
This review summarizes the latest data regarding the clinical aspects, radiological and therapeutic of major neurologic manifestations associated with antiphospholipid antibodies.
神经紊乱是与抗磷脂综合征(APS)相关的最常见和最重要的临床特征之一。其表现多样,包括脑卒中、短暂性脑缺血发作、斯-约综合征、癫痫发作/癫痫、痴呆、认知障碍、头痛/偏头痛、舞蹈病、多发性硬化样表现、横贯性脊髓炎、眼部症状和吉兰-巴雷综合征。
我们复习了关于神经紊乱和 APS 的最新数据。
在年龄<45 岁的患者中,20%的脑卒中可能与 APS 相关。本研究组最近报道了原发性 APS 与周围神经病之间的相关性。仅有一项研究通过电生理学研究调查了诊断为 PAPS 的患者中周围神经病的发生情况,结果显示 35%的患者存在改变。APS 中神经系统受累的机制被认为主要是血栓形成。然而,已经描述了其他机制,如与神经组织结合、扰乱其功能并产生即刻致病作用的抗磷脂抗体。
本综述总结了与抗磷脂抗体相关的主要神经表现的临床、影像学和治疗方面的最新数据。