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3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache
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[Vasculitis as a reason of chronic headache]
I Ataia1, C Casaulta, R O von Vigier
1Medizinische Universitäts-Kinderklinik, Inselspital, Bern. iris.ataia@ksgr.ch
Praxis
|June 14, 2008
Summary
Systemic lupus erythematosus (SLE) can manifest with neurological symptoms like chorea and stroke in adolescents. Early diagnosis and combined immunosuppressive and antithrombotic therapy are crucial for managing severe SLE complications.
Area of Science:
- Pediatric Rheumatology
- Neurology
- Nephrology
- Cardiology
Background:
- Systemic lupus erythematosus (SLE) is a complex autoimmune disease with diverse clinical presentations.
- Neurological and systemic manifestations in adolescents require thorough investigation.
Observation:
- A 13-year-old girl presented with fever, rash, chorea, headache, personality changes, fatigue, arthralgia, and weight loss.
- Investigations revealed multi-organ involvement including pericarditis, aortic insufficiency, renal disease, and hemolytic anemia.
- Cerebral magnetic resonance imaging (MRI) demonstrated extensive cerebrovascular events including thrombosis and vasculitis.
Findings:
- Diagnosis of SLE was confirmed by positive antinuclear antibody (ANA), anti-double-stranded DNA (anti-dsDNA), and anticardiolipin antibodies.
- Neurological deterioration with reduced vigilance and dysarthria indicated acute cerebrovascular complications.
- Cerebral MRI confirmed right middle cerebral artery thrombosis, left cerebral artery vasculitis, and multiple ischemic lesions.
Implications:
- Prompt and aggressive immunosuppressive therapy (corticosteroids, cyclophosphamide) alongside antithrombotic treatment can improve outcomes.
- This case highlights the importance of considering SLE in adolescents with unexplained neurological and systemic symptoms.
- Multidisciplinary management is essential for addressing the complex multisystemic involvement in pediatric SLE.
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