Neuropsychiatric systemic lupus erythematosus: tools for the diagnosis

Neurological involvement is considered to be a serious complication of systemic lupus erythematosus (SLE). Neuroimaging plays an important role in detecting neurological abnormalities in SLE patients. Conventional magnetic resonance imaging (cMRI) is generally the most valid neuroimaging technique for detecting alterations in the central and peripheral nervous systems. However it may occasionally fail in neuropsychiatric SLE (NPSLE). This is especially the case when the image is not very clear and may depend on the wide variety of neurological and psychiatric manifestations that define this disease. During the last twenty years, this has led to the testing of other radiological instruments, such as single photon emission computed tomography (SPECT), which is complementary to cMRI and seems to furnish additional information, and colour Doppler sonography, which provides minimal additional benefits. Our paper aims to provide a general overview of NPSLE, focusing particularly on the strengths and weaknesses of modern neuroimaging.