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[Neurolupus with dementia manifestations. 2 cases]
J P Camdessanche1, D Michel, P Cathébras
1Service de Neurologie, Hôpital de Bellevue, CHU de Saint-Etienne.
Revue Neurologique
|July 1, 1997
Summary
Dementia can manifest in young patients with systemic lupus erythematosus (SLE), presenting as frontal lobe deficits. Cyclophosphamide treatment proved effective in one case of neurolupus.
Area of Science:
- Neurology
- Immunology
- Psychiatry
Background:
- Disseminated lupus erythematosus (SLE) can present with neurological complications, termed neurolupus.
- Dementia is an uncommon manifestation in young SLE patients, particularly without focal neurological signs.
Observation:
- Two young patients with SLE developed dementia during lupus flares.
- Case 1: A psychiatric syndrome complicated by dementia during a lupus flare, with partial regression.
- Case 2: Moderate dementia and hearing loss progressed to severe mental deterioration.
Findings:
- Both patients exhibited frontal clinical signs and neuropsychological deficits.
- Neuroimaging (CT, MRI) revealed lesions consistent with frontal and/or frontobasal dementia.
- Neurolupus should be considered in young SLE patients presenting with dementia.
Implications:
- This highlights the potential for SLE to cause significant cognitive impairment in young individuals.
- Early recognition and appropriate treatment, such as cyclophosphamide, may improve outcomes in neurolupus-related dementia.
- Further research is needed to understand the mechanisms and long-term prognosis of dementia in SLE.