When lupus affects your brain, it can cause psychiatric symptoms. People with neuropsychiatric lupus tend to have shorter life expectancies, but treatments are available.
Systemic lupus erythematosus (SLE) is a chronic autoimmune condition that can cause inflammation anywhere in the body. When lupus affects the brain and spinal cord, it’s called neuropsychiatric lupus, lupus cerebritis, or central nervous system (CNS) lupus.
Neuropsychiatric lupus (NPSLE) can trigger symptoms such as headaches, mood disorders, cognitive impairments, seizures, and stroke.
This article provides an overview of NPSLE causes, symptoms, diagnosis, and treatment.
A healthy immune system protects your body from organisms that cause disease, such as viruses and bacteria. But with lupus, your immune system mistakenly attacks its own organs and tissues.
Sometimes, lupus affects one or more parts of your nervous system — including the brain and spinal cord — and this leads to NPSLE. Medical experts have linked NPSLE to a wide range of cognitive and psychiatric symptoms.
How often does lupus affect the nervous system?
It’s not entirely clear how many people with lupus experience NPSLE, but research suggests it’s common.
The authors of a 2021 review of studies suggest that an estimated 37–95% of people with lupus experience neuropsychiatric symptoms.
They explain that the range is so wide because of differences in how people define and study NPSLE. For instance, some researchers include mild symptoms in their studies, while others don’t.
NPSLE can affect your central, peripheral, and autonomic nervous systems. As a result, there are many possible NPSLE symptoms.
The American College of Rheumatology developed a
Less common NPSLE syndromes include:
It can be hard to know for sure whether nervous system symptoms are due to lupus or another condition. To diagnose NPSLE, your doctor will try to rule out other possible explanations for your symptoms.
There are no standardized diagnostic criteria for NPSLE, but doctors typically look for neuropsychiatric symptoms that appear alongside other signs of SLE, such as skin lesions, inflammation, and immune system activation.
They’ll start by asking you about your symptoms, any medications you take, and your medical and family history. After that, they’ll conduct a thorough physical examination.
Depending on their findings, they may order other tests. These might include:
NPSLE can look very different from one person to the next. As a result, there’s no standardized treatment for it. Doctors typically prescribe SLE treatments alongside other symptom-specific medications.
The authors of the 2021 review identified some treatments for common NPSLE syndromes, which we outline in the table below.
| NPSLE syndrome | Treatment(s) |
|---|---|
| headaches | nonsteroidal anti-inflammatory drugs |
| cerebrovascular disease | low dose aspirin blood thinners (anticoagulants) or antiplatelet therapy lifestyle changes to improve cardiovascular health |
| cognitive dysfunction | no known treatments |
| seizures | antiseizure medications |
| chorea and other movement disorders | dopamine antagonists |
| anxiety and mood disorders | antipsychotic drugs antidepressants anxiolytics |
It’s not clear what causes NPSLE, but as with lupus, experts believe that immune system dysfunction plays a role.
Researchers have identified
- autoantibodies
- cell-mediated inflammation
- cytokines
It’s not clear why some people with SLE develop neuropsychiatric symptoms while others don’t.
According to a different
- the presence of certain genes, autoantibodies, or cytokines
- accelerated atherosclerosis
- high lupus activity
- having lupus for a long time
The authors also cite previous research that suggests that among people with lupus, neuropsychiatric symptoms are more common in females, while seizures are more common in males.
In addition, people of African and Asian descent are more likely to report symptoms of NPSLE, while the condition tends to be more severe among white people.
People with NPSLE have a higher risk of death compared with people with SLE. Some research also links severe NPSLE symptoms to a lower chance of survival.
For instance, according to a
What’s the life expectancy for people with neuropsychiatric lupus?
The life expectancy for people with NPSLE is significantly lower than that of people without the condition.
According to the same 2020 study, people with severe NPSLE were more likely to die before the age of 50 years.
When SLE causes neuropsychiatric symptoms, it’s called NPSLE. Symptoms include seizures, anxiety and mood disorders, and cognitive impairment.
While NPSLE appears to be relatively common among people with lupus, researchers don’t understand it all that well. Research into causes, diagnosis, and treatments is ongoing.
It’s important to talk with a doctor if you have SLE and notice neurological or psychiatric symptoms. Taking medications to target key symptoms may be able to help.