[Lupus erythematosus and the central nervous system]

Central nervous system (CNS) involvement in early stages of systemic lupus erythematosus (SLE) and even before it's precise diagnosis is increasingly observed. Clinically predominant are non - focal neuropsychiatric symptoms (migrainous phenomena and depressive disorders ). Actual literature on their features, and - beside the classical - recent pathophysiological models of cerebral Le including evidence of autoimmunological processes are reviewed. In patients with doubtful diagnosis the "classical signs of SLE" are evidently of decreasing diagnostic value, whereas extended neuroimmunological laboratory investigations and 15O-positron emission tomography contributed a great deal towards detection of CNS-disease. At present, in pharmacotherapy of CNS-Le corticosteroides alone are preferably used rather than their fixed combination with immunosuppressive agents like azathioprin . In spite of an improved prognosis of SLE complications from CNS-involvement become the main cause of SLE-patients' deaths beyond the fifth year after diagnosis.