Association between antiphospholipid antibodies and epilepsy in patients with systemic lupus erythematosus

Abstract

Objective. To determine whether the occurrence of seizures is correlated with the presence of serum antiphospholipid antibodies (aPL) in systemic lupus erythematosus (SLE) patients.Methods. The study included 221 unselected patients with SLE. Of these, 21 patients with epileptic seizures not attributed to any cause other than SLE were identified. Epilepsy was diagnosed by clinical history and electroencephalography. Blood samples were tested for the presence of antibodies to cardiolipin (aCL, IgG and IgM isotypes) and lupus anticoagulant (LAC).Results. LAC was detected in 43.8% of the patients with epilepsy and in 20.8% of controls (P = 0.057). A statistically significant association was found between moderate-to-high titers of IgG aCL and the presence of seizures (P = 0.02). Brain computed tomography and/or magnetic resonance imaging scanning was performed in 14 patients. All patients with abnormal features found on these tests had positive aPL (P = 0.03). Nine patients (42.9%) had at least 1 of the classic features associated with the aPL syndrome. Conclusion. We confirmed that epilepsy as a primary neuropsychiatric event is significantly associated with moderate-to-high titers of IgG aCL in SLE

Neurological dysfunction and hyperactive behavior associated with antiphospholipid antibodies. A mouse model.

“…A significant association has been reported between aPL and recurrent ischemic events, strokes, or transient ischemic attacks (7)(8)(9)(10). Likewise, several studies have reported the existence of a link between aPL and seizures in patients with SLE or in patients with the primary syndrome (11,12). Ocular disturbances (amaurosis fugax [2,13] and optic atrophy [2]), multiinfarct dementia, dementia of nonischemic origin (6,14,15), and chorea (16) have also been reported in patients with primary APS.…”

Electroencephalography in the assessment of neuropsychiatric manifestations in antiphospholipid syndrome and systemic lupus erythematosus

“…In that description, several neuropsychiatric features (headache, migraine, epilepsy, chorea, and cerebrovascular events such as stroke, transient ischemic attacks, visual field defects, and progressive cerebral ischemia) were noted (3). To date, APS has been associated with cerebrovascular disease (4), dementia (5), epilepsy (6,7), headaches/migraines (8), transverse myelitis, cognitive dysfunction (9), chorea (10), psychosis (11), optic neuropathy (12), and sensorineural hearing loss (13). The international (Sapporo) classification criteria (14) for APS include cerebrovascular disease, when it is documented on brain magnetic resonance imaging (MRI) as stroke or small-vessel disease.…”

Autoimmune Diseases Associated with Epilepsy

“…Bu konuda yapılan araştırmalar en azından, SLE hastalarında izlenen nörolojik tutulumdan sorumlu en önemli faktörün anti-fosfolipid antikorlarının olmadığını telkin etmektedir. [13][14][15] NP-SLE'de beyinde aseptik menenjit ve vaskülite sekonder iskemik ve demiyelinizan lezyonlar izlenebilir. Lezyonlu hastalarda parenkimal irritasyon zemininde semptomatik epilepsi de ortaya çıkabilmektedir.…”