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ihate2shave
07-08-2006, 07:22 AM
How is lupus where the antibodies attack the central nervous system different from multiple sclerosis, where antibodies also attack the CNS? Like some other posters I have occasional numbness and tingling, vertigo, balance problems (don't know which side is up when I get too tired or move my head too fast), a slight intermittent tremor, mood swings and constant fatigue. The blood tests apparently point to SLE and not MS, but what are the different processes in the body with the two when the location of the autoantibodies are so similar, as are the symptoms?

Also what is the difference between neuropsychiatric and CNS SLE?

Thank you!

Sheryl
07-08-2006, 09:43 AM
Hi!
That's a really good question - and something I went through when I was diagnosed a few months ago - I just wrote a long post about it here this morning:

http://wehavelupus.com/message-board-forum/viewtopic.php?p=7043#7043

I will give you my non-medical understanding of it based on what I went through, but I bet Susie will have something much more authentic and informative.

MS is a progressive disease which only attacks the CNS, meaning brain and spine. In order to be diagnosed with MS you must have two distinct, separate episodes "separated in time and space," meaning 3 months apart and at different locations. Thats why the name "Multiple" and "Sclerosis" which is the lesion on your brain or spine. MS limits its autoimmune attacks to the myelin which is the outer covering of the nerve cells in the spine and brain.

There are many similarites to lupus:
Both are autoimmune diseases
Both are incurable
Both have flares and remissions
Both can cause fatigue

There is no specific blood test for MS, only indicators that strongly suggest it, including certain tests of the spinal fluid. There is not a specific test for lupus either but certain antibodies like the ANA test and the Anti-dsDNA can give a "strong suggestion," when present with other symptoms.

I know a lot less about CNS lupus, although it is what I apparently have! In my case, antibodies attacked the myelin like they do in MS, which is why it was so confusing, but all the blood tests indicated lupus not MS. In CNS Lupus the immune system can attack other parts of the CNS like the nerve cells themselves or the blood vessels in the brain. Another very serious type of CNS lupus is called Vasculitis which causes inflammation of the blood vessels in the brain.

I also have APS which is listed as a type of CNS lupus, where antibodies affect the blood. This is considered part of CNS lupus because it can cause strokes.

A good website for MS is the national ms scociety, and for CNS lupus the
Lupus Foundation of America website's education section has a good description.

I hope I helped and didn't just confuse you worse!! Maybe some of the others here with CNS lupus have more info for us?

ihate2shave
07-08-2006, 10:14 AM
Hi Sheryl! Yes, your post is the one that prompted my question... didn't want to hijack your thread so did a spinoff. :o

Your reply helps. Your description makes me wonder if MS is a very specific type of SLE... Maybe even the doctors can't answer that question yes or no, because even the best ones can't fully explain what happens and why.

One question I asked of a knowledgeable assistant in my rheum's office, is: Does lupus autoimmune activity tend to happen in the same location where there is/was an infection? She said not always, but often this is true. I'd asked her because in me SLE manifested itself within a year of getting acute mononucleosis, and my rheum said the SLE was "viral in etiology." (there were other triggers too) After all, most people w/mono have a full recovery. So I'm thinking, where exactly does the mono reside? Is it by coincidence that I was exhausted and very "out of it" with the mono, then when the lupus developed, it manifested itself in the same "location" - in my CNS.

It's funny, when my rheum first diagnosed me he said well, luckily it's not in your vital organs. Of course he meant the liver and kidney (and I'm grateful, God knows) - but I knew it was in my brain! So I joked, well thanks for saying my brain is not a vital organ -- and the sorry thing is, you're right!! :lol: :lol:

One more question... anybody know if the little autoimmune gremlins act differently depending on what type of tissue they're in?

Oh! I lied - another question... do you have a tremor, cuz I do and it's freaky. It seems to happen when I move my eyes too quickly. What the heck is that about??

Sheryl
07-08-2006, 03:48 PM
Hi -
No I don't have a tremor (yet), but I've heard a lot of people with APS do... interesting about the mono. I had a really bad tooth abscess about a month before I got sick. I think that may have triggered the attack on my spine even though the "gremlins" were probably lurking just waiting for a chance.

My rheumatologist said something similar to yours - that lupus often but not always seems to stay in the same areas it first attacked. So if our CNS is attacked our joints or kidneys might not be... That was when he said lupus might someday be broken out and described as 8 different diseases. It sure is a confusing disease, that's all I know!