What is neuropsychiatric lupus?

Neuropsychiatric lupus is a general term used to describe the neurological and psychiatric symptoms that arise in 10% to 30% of patients diagnosed with systemic lupus erythematosus, the most severe form of lupus. Many people refer to systemic lupus erythematosus as simply "lupus" as it is the most common form of this autoimmune disorder, as well as being the most serious. Treatment for neuropsychiatric lupus focuses on treating the underlying lupus and neuropsychiatric symptoms with the goal of keeping the patient as comfortable as possible.

Like other autoimmune disorders, lupus is characterized by a profound malfunction of the immune system. In lupus patients, the immune system becomes confused and begins to attack itself, causing inflammation, internal legion, damage to internal organs, and a variety of other symptoms. Historically, lupus was always fatal, but modern medical treatments have made lupus much easier to manage, greatly reducing the mortality rate. Survival rates of up to 20 years with lupus are not uncommon in regions where people have access to high-quality health care.

In some patients, in addition to the expected lupus symptoms, neuropsychiatric symptoms arise. The two most common features of neuropsychiatric lupus are frequent severe headaches and a radical decline in motor function. Many people with this condition also experience gait problems, having difficulty walking and balancing. Depression, stroke, psychosis, dementia, delirium, cognitive dysfunction, movement disorders, and impaired memory are also associated with neuropsychiatric lupus.

You may also hear neuropsychiatric lupus called neuropsychiatric systemic lupus erythematosus (NPSLE). The precise causes of neuropsychiatric symptoms are not really understood. Some doctors theorize that the condition is related to inflammation and injury to the brain, which would explain many of the symptoms, although NPSLE patients do not always show a marked increase in inflammation and injury. Damage to internal organs can also contribute to the development of neuropsychiatric lupus.

Neuropsychiatric symptoms usually arise after someone has already been diagnosed with lupus. This helps doctors narrow down the cause of symptoms, since a wide variety of conditions can cause similar physical and cognitive symptoms. Various medications can be used to treat symptoms, and lupus treatment can also be adjusted to accommodate neuropsychiatric lupus. Patients with severe cases may be forced to arrange for home care or a stay in a residential facility, as they may become a danger to themselves or others, especially as disability progresses.

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