Could microvascular ischemic demyelination be due to lupus?
Patient: I am a 48 yo white female with a history of epilepsy, SLE, hypothyroidism, SVT, etc. Recently I experienced at severe headache with dizziness, sensation of fainting, and nausea. I have had migraines in the past with neurologic symptoms of partial vision loss. This recent episode was different. My doctor ordered a cerebral MRI and the results show 'chronic microvascular ischemic demyelination."  Could this be a new manifestation of the lupus? Doctor: Central nervous system (CNS) lupus refers to several different neurological and/or behavioral clinical syndromes in patients with systemic lupus erythematosus (SLE). The neuropsychiatric manifestations of lupus, which are frequent, vary from mild to severe and are often difficult to distinguish from other conditions and etiologies. Any location within the central nervous system (brain and spinal cord) may be affected with a variety of presentations from mild cognitive dysfunction to seizures, stroke or coma.summarizes the major manifestations of CNS lupus.Major manifestations of CNS lupus described below:- Cognitive dysfunction (not thinking clearly, memory deficits etc.)HeadachesSeizureAltered mental alertness (e.g. stupor or coma)Aseptic meningitis (inflammation of the covering of the brain)Stroke (disturbance of the blood supply to different parts of the brain)Peripheral neuropathy (e.g. numbness, tingling, burning of the hands and feet)Movement disordersMyelitis (disruption) of the spinal cord. Visual alternationsAutonomic neuropathy (e.g., flushing reaction or mottled skin)                         Hope this will helpful to you...