suMMARY Twenty-five patients with 29 episodes of active systemic lupus erythematosus with central nervous system involvement were studied according to a uniform protocol. Brain scans were found to be abnormal in all patients studied, and electroencephalograms were abnormal in 20/25 patients. Serial brain scanning was found to be useful in the diagnosis of exacerbations and the monitoring of corticosteroid dosage.In a recent study of 110 patients with systemic lupus erythematosus (SLE), we found major neuropsychiatric manifestations in 44 patients (40%) including severe psychiatic disturbances or localised neurological lesions (Lee et al., 1977). The reported frequency of such manifestations in SLE ranges from 14-75% (Bennahum and Messner, 1975;Feinglass et al., 1976), the incidence varying with the criteria used for inclusion.In many instances, minor neuropsychiatric disturbances or severe headaches without localising signs are excluded because of poor neuropsychiatric and neuropathological correlations (Johnson and Richardson, 1968); yet these might represent active SLE with central nervous system (CNS) involvement. Available diagnostic procedures such as CSF examination or arteriography are frequently not helpful in diagnosing active CNS lupus.Recent evidence seems to indicate that the radionuclide brain scan can be useful in the diagnosis of CNS involvement in SLE (Bennahum et al., 1974). The present study reports our experience with radionuclide brain scan in SLE.
Material and methods
PATIENTSTwenty-five patients with active CNS SLE were studied. There were 21 females and 4 males, with a mean age of 34 9 years (range 21-75 years with only 3 patients over the age of 50) and a mean duration of SLE of 4 7 years. These patients were studied