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Published on: October 4, 2021
Bilateral reversible basal ganglia changes associated with dystonia and hemifacial spasms in central nervous system
Kit Wu1, Loucas Christodoulou1, Ata Siddiqui1
11 Department of Neurology, Guy's & St Thomas' Hospitals NHS Trust, London, UK ; 2 Department of Paediatric Neurology, Chelsea & Westminster Hospital NHS Foundation Trust, London, UK ; 3 Department of Neuroradiology, 4 Department of Rheumatology, Guy's & St Thomas' Hospitals NHS Trust, London, UK.
Abstract:
We report a 40-year-old woman with systemic lupus erythematosus (SLE) and associated inflammatory polyarthritis who presented with acute facial dystonic spasms. Her speech was also affected. An MRI brain showed bilateral symmetrical basal ganglia signal change on T2. This movement disorder was due to an acute manifestation of her lupus. Her symptoms resolved rapidly following treatment with (oral) steroids. Repeat MRI brain at 1 month showed complete resolution of the basal ganglia signal change. This is the first time that facial spasms and dystonia with corresponding MRI changes are reported as a presentation of lupus affecting the central nervous system (CNS lupus).
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