Facultad de Medicina, Universidad Autónoma de Guadalajara, Guadalajara, Jalisco, Mexico.
Department of Psychiatry, Mayo Clinic- Rochester, Rochester, MN, United States.
Seizure. 2021 Mar;86:161-167. doi: 10.1016/j.seizure.2021.02.021. Epub 2021 Feb 17.
Systemic lupus erythematosus is a systemic autoimmune disease that affects the central nervous system, either by direct neuronal damage, injury to brain vessels, or by pathogenic mechanisms indirectly induced by immune mechanisms related to the production and deposition of immune complexes. The prevalence of explicit episodes of seizures among SLE patients, varies from 2 to 8%. In some cases, patients with positivity for antiphospholipid or anti-β2 glycoprotein antibodies are found to be more prone to exhibit seizures compared to seronegative patients, other subjects at risk are carries of gene abnormalities codifying for ion channels. The exclusion of vasculitis or thrombosis is required for accurate treatment, imaging studies and alternative sequences are mandatory in patients with known SLE who present with a seizure. Several statements regarding SLE-related seizure remain to be decoded. In this scoping review we analyzed published information about prevalence, pathogenesis, clinical characteristics, diagnostic and therapeutic SLE patients that manifest a seizure, our objective is to provide with useful information for prompt diagnosis and individualized treatment.
系统性红斑狼疮是一种系统性自身免疫性疾病，可通过直接神经元损伤、脑血管损伤或通过与免疫复合物产生和沉积相关的免疫机制间接诱导的致病机制影响中枢神经系统。SLE 患者明确发作性癫痫的患病率从 2%到 8%不等。在某些情况下，与抗磷脂或抗β2糖蛋白抗体阳性的患者相比，发现癫痫发作的患者更容易发生，其他风险患者是编码离子通道的基因异常携带者。为了准确治疗，需要排除血管炎或血栓形成，对于已知患有 SLE 并出现癫痫发作的患者，需要进行影像学研究和替代序列检查。关于与 SLE 相关的癫痫发作仍有一些需要解释的问题。在本次范围综述中，我们分析了关于患病率、发病机制、临床特征、诊断和治疗表现为癫痫发作的 SLE 患者的已发表信息，我们的目的是提供有用的信息，以便快速诊断和个体化治疗。
