[Cerebral strokes in patients with systemic lupus erythematosus]

We examined a group of 83 patients (81 females and two males) diagnosed as systemic lupus erythenatosus (SLE) aged 19-77, with the mean duration of the disease of seven years. All patients had neurological examination and electroencephalography (EEG) complemented with magnetic resonance image (MRI) and single photon emission computed tomography (SPECT) in same cases. Among 83 patients we found the group of five (females) showing acute, stroke-like symptoms. Subarachnoid haemorrhage from a vascular malformation was diagnosed in one case. In four cases ischemical syndromes were observed mainly without strong clinical expression, with tendency to recede. In one patient the stroke was the first symptom of SLE. All these patients revealed abnormalities both in neurological examination and in neuroimaging techniques--as small, hyperintensive foci in MRI and multiple, diffused areas of decreased cerebral blood flow found in all but one cases in SPECT which seems to be the most sensitive method. In conclusions we want to stress that observed ischemic syndromes in patients with SLE were acute but of moderate intensity, with tendency to recede swiftly; transient ischemic attacks (TIA) were comparatively frequent. Acute stroke-like episodes might be the first symptom of SLE.