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Neuropsychiatric lupus is a condition that affects 10-30% of patients with systemic lupus erythematosus, causing neurological and psychiatric symptoms. Treatment focuses on managing lupus and symptoms, while the cause of neuropsychiatric symptoms is not fully understood. Severe cases may require home or residential care.
Neuropsychiatric lupus is an umbrella term used to describe the neurological and psychiatric symptoms that emerge in 10-30% of patients diagnosed with systemic lupus erythematosus, the most severe form of lupus. Many people refer to systemic lupus erythematosus simply as “lupus,” as it is the most common form of this autoimmune disease, as well as being the most serious. Treatment for neuropsychiatric lupus focuses on addressing the underlying lupus and neuropsychiatric symptoms with the goal of keeping the patient as comfortable as possible.
Like other autoimmune diseases, lupus is characterized by a profound malfunction of the immune system. In lupus patients, the immune system becomes confused and begins attacking itself, causing inflammation, internal leg ulcers, internal organ damage, and a variety of other symptoms. Historically, lupus has always been fatal, but modern medical treatments have made managing lupus much easier, greatly reducing the death rate. Survival rates of up to 20 years with lupus are not uncommon in regions where people have access to high-quality medical care.
In some patients, neuropsychiatric symptoms emerge in addition to the expected lupus symptoms. 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 have walking problems, difficulty walking and balance. Depression, stroke, psychosis, dementia, delirium, cognitive dysfunction, movement disorders, and impaired memory are also associated with neuropsychiatric lupus.
You may also hear neuropsychiatric lupus referred to as 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 lesions in the brain, which would explain many of the symptoms, although NPSLE patients do not always show a marked increase in inflammation and lesions. Damage to internal organs can also contribute to the development of neuropsychiatric lupus.
Usually, neuropsychiatric symptoms emerge after someone has already been diagnosed with lupus. This helps doctors narrow down the cause of symptoms, as a wide variety of conditions can cause similar physical and cognitive symptoms. Various medications can be used to address the symptoms, and lupus treatment can also be tailored to accommodate neuropsychiatric lupus. Patients with severe cases may be required to arrange for home care or residential care, as they may become a danger to themselves or others, especially as their disability progresses.
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