Early detection of neurological involvement in systemic lupus erythematosus patients

In lupus the neurological abnormalities usually mimic many primary neurological diseases and often represent the only manifestation of SLE for several years before the onset of other features of the disease. The aim of this study was to investigate lupus patients to obtain electrophysiological data of possible neurological abnormalities even in the absence of neuropathy symptoms. Thirty-eight SLE patients, twenty healthy volunteers and 10 steroid-using control subjects were included. Eighteen were asymptomatic but 20 of them had neuropathy symptoms. Median, ulnar and peroneal nerve motor, median, ulnar and sural nerve sensory conduction velocities, median and tibial somatosensory evoked potentials (SEP) were recorded. 23.6% of all lupus patients had peripheral nerve conduction slowing and 39.5% had SEP abnormalities; almost half of them being asymptomatic. 44.7% of the total had carpal tunnel syndrome; again almost half of them (47%) were asymptomatic. There was no significant correlation between the electrophysiologic parameters and the clinical and laboratory parameters of the disease. In lupus patients, SEP abnormalities were more pronounced than peripheral findings, reflecting the CNS involvement more common than the peripheral neuropathy. Therefore, we suggest performing the electrophysiological studies in lupus patients, even in the asymptomatic ones, early in the course in order to detect the nervous system involvement.