Central Nervous System Manifestations of Antiphospholipid Syndrome

Neurologic manifestations are common in patients with antiphospholipid antibodies and include stroke, seizures, dementia, cognitive dysfunction, chorea, migraine, psychosis, and demyelinating disease. Many of these disorders mimic their idiopathic counterparts, yet treatment for antiphospholipid antibody-associated disease can be quite different compared with treatment of CNS disease not associated with these antibodies. For patients with antiphospholipid antibody-associated neurologic disease, anticoagulation or immunosuppressive therapy or both may significantly improve their symptoms. Thus, one should have a high index of suspicion for antiphospholipid syndrome in the appropriate clinical context.