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系统性红斑狼疮的临床神经学、电生理学及脑部CT扫描结果

Clinical neurological, electrophysiological, and cerebral CT scan findings in systemic lupus erythematosus.

作者信息

Omdal R, Selseth B, Kløw N E, Husby G, Mellgren S I

机构信息

Department of Neurology, University Hospital of Tromsø, Norway.

出版信息

Scand J Rheumatol. 1989;18(5):283-9. doi: 10.3109/03009748909095031.

Abstract

Thirty SLE patients underwent clinical neurological examination, electrophysiological studies, cerebral computer tomographic (CT) scans, and blood sampling. Nineteen patients (63%) had clinical neuropsychiatric and 10 patients (33%) had clinical neuromuscular manifestations. Migrainous headache affecting 11 patients (37%) was the most prevalent clinical manifestation. Electrophysiological testing revealed abnormal electroencephalography in 10 patients (33%). Abnormal electromyography and nerve conduction velocity were found in 13 (43%) and 7 (24%) patients respectively. Abnormal visual evoked response was detected in 2 patients. Cerebral CT scans displayed cerebral atrophy in 20 patients (71%), while 6 patients (21%) had cerebral infractions. Disease activity assessed by two different tests revealed a higher prevalence of cerebral infarctions, classical migraine, muscular weakness, and pathological electromyography and nerve conduction velocity in the higher disease activity groups. Cerebral infarctions were only found among anti-Ro negative patients, but apart from this, no significant association could be found between coagulopathy, circulating immune complexes, cryoglobulins, routine immunological tests, medication, and any clinical, electrophysiological or cerebral CT pathology.

摘要

30例系统性红斑狼疮患者接受了临床神经学检查、电生理研究、脑部计算机断层扫描(CT)以及血液采样。19例患者(63%)有临床神经精神表现,10例患者(33%)有临床神经肌肉表现。偏头痛影响了11例患者(37%),是最常见的临床表现。电生理测试显示10例患者(33%)脑电图异常。分别有13例(43%)和7例(24%)患者肌电图和神经传导速度异常。2例患者检测到视觉诱发电位异常。脑部CT扫描显示20例患者(71%)有脑萎缩,而6例患者(21%)有脑梗死。通过两种不同测试评估的疾病活动显示,在疾病活动较高的组中,脑梗死、典型偏头痛、肌肉无力以及病理性肌电图和神经传导速度的患病率更高。脑梗死仅在抗Ro阴性患者中发现,但除此之外,在凝血障碍、循环免疫复合物、冷球蛋白、常规免疫测试、药物治疗以及任何临床、电生理或脑部CT病理之间未发现显著关联。

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