11-02-2007, 08:14 AM
I have a question about brain involvement and lupus. I have been having pains in my head that last like 2 seconds but they are sharp. I have a huge problem with going into a store with flourescent lights. I have to wear sunglasses and hurry through the store but I still feel a bit sick to my stomach because sunglasses cannot keep all of the filtration out. Also, my head feels wishy washy. I have begun to notice, the last month or so, that I am forgetting a lot more, dizzy and feels like I cannot drive. Not because of the dizziness but because of this weird feeling in my head. I cannot explain this and it probably sounds ridiculous. I am having episodes with equilibrium as well. Does any of this sound like a neurology issue to anyone?
Thanks for reading.
11-02-2007, 09:11 AM
There may be several issues going on. One of the common symptoms of Lupus is sensitivity to the sun, UV, UVA and UVB rays and overhead lights (fluorescent tube lights, which mainly emit UVB, and photocopiers, which emit mainly UVA). Abnormal light sensitivity, or "photosensitivity," is a major feature of both systemic lupus erythematosus (SLE), which can affect any organ or system of the body, and cutaneous lupus erythematosus (CLE), which is mainly limited to the skin.
People with lupus often experience headaches, confusion, difficulty with concentrating, fatigue and occasionally have seizures, strokes, or other signs of nervous system involvement. Nerve tissue may be damaged when antibodies attack nerve cells or blood vessels. The nervous system requires an uninterrupted flow of blood to supply its tissues with oxygen and nutrients necessary for normal functioning. Nutrients and oxygen are delivered through blood vessels that feed the brain, spinal cord and nerves. If blood flow is slowed or interrupted, the cells of the nervous system are injured, unable to function normally, and symptoms develop. The symptoms that occur vary depending on the location and extent of the tissue injury.
The nervous system is divided into three parts. The central nervous system (CNS) consists of the brain and spinal cord. The peripheral nervous system is comprised of nerve fibers that supply the skin and muscles with the power needed for sensation and movement. The autonomic nervous system helps to regulate spinal, peripheral nerves and innervates the internal organs.
VASCULITIS: CNS vasculitis is inflammation of the blood vessels of the brain. This occurs in up to 10% of all lupus patients, and is the only form of CNS disease that is included in the American College of Rheumatology criteria for defining and diagnosisng SLE. The symptoms of CNS VASCULITIS include:high fevers, seizures, psychosis and meningitis-like stiffness of the neck. This can rapidly progress to stupor and coma if not aggressively managed. CNS vasculitis is the most serious form of SLE and usually requires hospitalization and high doses of corticosteroids. Seizures occur when injured or scarred brain tissue becomes the focus of abnormal electrical discharges. They may be a one-time occurrence or a persistent problem. Anti-convulsant medications are used to prevent seizures by controlling the brain's abnormal electrical discharges.
Most of us, at some point during the course of our lupus, have dealt with feelings of confusion, fatigue, memory problems, and difficulty expressing our thoughts. This collection of symptoms is called "cognitive dysfunction" and is found in many people with mild to moderately active Lupus. The reason for these symptoms is not known but it may have something to do with changes in how a group of chemicals known as cytokines are handled or may be related to certain parts of the brain not getting enough oxygen. Antimalarials and/or steroids have been found to be helpful, but the management of cognitive dysfunction is often frustrating and currently there is no sure-fire therapy is available.
People with lupus also experience headaches which can beunrelated to their lupus, i.e., sinus headache, tension headache and migraine. Approximately 20% of patients with SLE (including me) have severe headaches which are related to the disease and known as "lupus headache." Lupus headaches are very similar to migraine headaches and may be seen more often in people who also have Raynaud's phenomenon. PET scans indicate abnormalities in blood vessel tone or the ability of a vessel to dilate or constrict. Lupus headaches are usually treated like tension headaches or migraines, although corticosteroids are often used and are usually helpful (they do not work on common migraines).
Organic Brain Syndrome:
Patients with a history of stroke or vasculitis usually experience damage to the brain that is repaired by scar tissue. This results in seizures as well as difficulty with muscular movement, memory, concentration and orientation. These patients are found to have organic brain syndrome and usually show no evidence of lupus activity in the blood or spinal fluid. Steroids treatment for this syndrome only makes the symptoms worse. Organic brain syndrome is treated with emotional support.
Medications used to treat SLE can cause side effects that are similar to the symptoms of central nervous system lupus. These include nonsteroidal anti-inflammatory drugs which occasionally cause headache, dizziness, and, meningitis-like symptoms. Anti-malarials (Plaquenil et al) in very high doses may cause psychosis. Corticosteroids are associated with agitation, confusion, moods swings, psychosis, depression, and in high doses, seizures. Withdrawal from steroids can lead to fatigue, aching, weakness, or seizures. Anti-hypertensive medications may be associated with loss of libido or depression. Your doctor will have to determine what is a side-effect of medication and what is a symptom of CNS lupus.
I hope that I've provided the information that you needed. Please let us know if you need anything further.
Peace and Blessings