Neurological manifestations of children with systemic lupus erythematosus

Area of Science:

• Pediatric Rheumatology
• Pediatric Neurology
• Systemic Lupus Erythematosus (SLE)

Background:

• Systemic Lupus Erythematosus (SLE) is a complex autoimmune disease with diverse clinical presentations.
• Neuropsychiatric manifestations (NPMs) are recognized complications of SLE, but their prevalence and spectrum in children require further elucidation.

Purpose of the Study:

• To determine the frequency and types of neuropsychiatric manifestations in a cohort of children diagnosed with SLE.
• To investigate the association between SLE and neurological findings, including seizures, encephalopathy, and peripheral neuropathy.

Main Methods:

• A cross-sectional study was conducted involving 21 children with established SLE diagnoses.
• Data collection included clinical assessments for neuropsychiatric symptoms, electroencephalograms (EEGs), neurophysiological tests, and neuroimaging (Computerised Axial Tomograms - CAT scans).

Main Results:

• Neuropsychiatric manifestations were observed in 15 out of 21 (71%) children.
• Generalized seizures (42.8%), encephalopathy (19%), and hallucinations (19%) were the most common NPMs. Cerebral atrophy was noted in 7/12 CAT scans, and 10 children had abnormal EEGs.
• While no clinical peripheral neuropathy was evident, 8 children showed neurophysiological evidence of neuropathy. Neurological symptoms preceded SLE diagnosis in 3 children.

Conclusions:

• Neuropsychiatric manifestations are highly prevalent in children with SLE, impacting a significant majority of the studied cohort.
• The findings underscore the importance of comprehensive neurological evaluation in pediatric SLE patients to identify a wide range of potential central and peripheral nervous system involvement.
• Early recognition and management of these neurological complications are crucial, given the potential for significant morbidity and long-term sequelae.