Neuropsychiatric lupus is a blanket term used to describe the neurological and psychiatric symptoms which emerge in 10 to 30% of patients diagnosed with systemic lupus erythematosus, the most serious form of lupus. Many people refer to systemic lupus erythematosus as simply “lupus,” since it is the most common form of this autoimmune disorder, in addition to being the most serious. Treatment for neuropsychiatric lupus focuses on addressing the underlying lupus and the 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 patients with lupus, the immune system gets confused and starts attacking itself, causing inflammation, internal legions, damage to the internal organs, and a variety of other symptoms. Historically, lupus was always fatal, but modern medical treatments have made management of lupus much easier, greatly reducing the fatality 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, in addition to the expected lupus symptoms, neuropsychiatric symptoms emerge. The two most common hallmarks 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, strokes, 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 patients with NPSLE do not always exhibit a marked increase in inflammation and lesions. Damage to the internal organs may also be a contributor 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 the symptoms, as a wide variety of conditions can cause similar physical and cognitive symptoms. Various medications may be used to address the symptoms, and the lupus treatment may also be adjusted to accommodate the neuropsychiatric lupus. Patients with severe cases may be obliged to arrange for in-home care or a stay in a residential facility, as they can become a danger to themselves or others, especially as the impairment progresses.