What is the most common kind of lupus brain involvement?
Many people with lupus—at least one in five—have trouble thinking clearly at some point and experiences memory problems, confusion, fatigue, or difficulty expressing thoughts. Called cognitive dysfunction, the condition likely occurs because blood stops flowing as smoothly to the brain as it should. This also can happen when lupus antibodies cross the "blood-brain barrier," directly damaging brain cells in areas that store memories and other important information. Cognitive dysfunction may come and go, but often steadily worsens over time.
What is "lupus fog?"
A part of cognitive dysfunction, some people with lupus get spells of "fogginess" when, for several seconds or minutes, they can not get to information that they know is in their heads. They may read the same sentence over and over again, for example. Or struggle with a normally easy task, like balancing a checkbook or dialing a familiar number.
What can be done about cognitive dysfunction and "lupus fogs?"
Reassurance from loved ones helps a lot. So can behavioral counseling, physical or speech therapy, biofeedback, techniques for relaxing the body and mind, and concentration strategies. A lupus diary can be useful to track when fogs happen and what works for dealing with them. Medicines may lessen the fatigue or depression that makes thinking hard. Doctors are learning a lot about how lupus antibodies hurt brain cells and are testing medicines for dementia that might some day help people with lupus.
Do other brain problems happen in people with lupus?
Blood flow to the brain feeds brain cells with nutrients (food) and oxygen. Strokes occur when this blood flow is interrupted and brain cells die from the lack of oxygen, causing symptoms such as tingling sensations and problems with vision, speech, and movement (including paralysis). People with lupus have a higher risk for stroke, especially the third or so who have "antiphospholipid antibodies" that make blood "sticky" and more likely to clot and stop or slow blood flow to the brain. Although uncommon, inflammation in the spinal cord or brain's blood vessels also happens with lupus and can lead to paralysis, seizures, difficulty judging reality, and loss of consciousness.
Can lupus change emotions and behavior?
Some people with lupus have mild but noticeable changes in behavior such as unusual feelings of fear or lack of fear, or loss of interest or curiosity. More commonly, the fatigue and pain of lupus is draining to the point that a person changes his or her outlook on life. Corticosteroids and other lupus medicines sometimes make matters worse by causing weepiness or other exaggerated feelings. The "emotional rollercoaster" of lupus is something that always should be discussed with a doctor.