[Ischemic lesion of the CNS in patients with systemic lupus erythematosus]

In a review of 240 patients with Systemic Lupus Erythematosus we found 12 (5%) with cerebral infarctions. The average patient age was 38 years and no relation with the duration of lupus was found. The most common neurologic manifestations were hemiparesis (67%), language disturbances (25%) and ataxia (25%). Clinical signs of diffuse involvement of Central Nervous System (CNS) were also present in 1/3 of the patients. In 5 cases (42%) no signs of lupus activity were found. In the remaining 7 (58%), where other manifestations occurred, all presented cutaneous vasculitis. Known risk factors for atherosclerotic vascular disease were common and 58% of the patients had at least one risk factor.

1. Recent onset cutaneous vasculitis should alert the physician to the possibility of CNS ischemic lesion and 2. The presence of risk factors for cerebrovascular disease (steroid therapy, hypertension and hypercholesterolemia) is frequent and may be controlled.