A Clinical Study on NPSLE in a Tertiary Care Hospital in Northeast India

ABSTRACT

Introduction: Neuropsychiatric Systemic LupusErythematosus (NPSLE) is a disease with central andperipheral nervous system manifestations. The diagnosis ofNPSLE is often a diagnostic challenge though the criteria forNPSLE is well-established.Objective: To study the prevalence and pattern ofneuropsychiatric manifestations in SLE.Materials and Methods: This hospital based observationalstudy was carried out from Nov 2017 to June 2018. A total of58 cases of SLE were assessed clinically and investigatedaccordingly. Special emphasis was given to look forNeurological involvement. MMSE, HAM A and HAM D scaleswere used for assessment of cognitive dysfunction, anxiety anddepression respectively. The disease activity was measured bythe SLEDAI.Results: In a total of 58 patients with SLE evaluated, 92%were female. The most common age group was 21 to 30 years.Mean age was 25.6 years. Nervous system involvement wasfound in 37 (63.79%) patients. Headache was the mostfrequent manifestation, present in 32 (55.17%) patientsfollowed by Cognitive dysfunction in 8 patients (13.79%).Seizure disorder was present in 6 (10.34%), acute confusionalstate in 2 (3.44%), depression in 4 (6.89%), anxiety in 2(3.44%) and psychosis in 2 (26.31%) patients. Asepticmeningitis and peripheral neuropathy was found in 2 (3.44%)and 1 (1.72%) patients respectively. Many of the patients hadmore than one neurological involvement. SLEDAI score washigh in SLE patients with neurological manifestations.Conclusion: The frequency of Neuropsychiatric involvementwas found in the majority of the patients with SLE andheadache was the most common manifestation. Patients withNPSLE showed high disease activity.