Lupus causes your immune system to attack your own organs and tissues, including your nervous system. This can result in mild symptoms such as headaches or numbness, but also serious conditions such as stroke or seizures.

Lupus, or systemic lupus erythematosus (SLE), is a systemic autoimmune disease. It occurs when your body’s immune system mistakenly attacks your own organs and tissues, such as your:

  • kidneys
  • joints
  • skin
  • blood vessels
  • nervous system

The nervous system is your body’s command center. It includes your brain, spinal cord, and a network of nerves. The nervous system regulates your body by sending messages between your brain and the rest of your body.

When lupus attacks your nervous system, it can cause mild symptoms such as headaches or numbness. It can also cause more serious symptoms such as seizures or stroke. When lupus affects your nervous system, it’s called neuropsychiatric SLE (NPSLE).

This article will detail the different symptoms that may occur if lupus attacks your nervous system and how to manage these symptoms.

Inflammation in your brain due to lupus can lead to confusion, memory loss, and trouble concentrating or expressing your thoughts. These cognitive issues are sometimes called “brain fog” or “lupus fog.” Your doctor may call it mild cognitive dysfunction.

Other symptoms of brain fog include:

  • difficulty multitasking
  • sleep problems
  • having trouble finding the right words
  • inability to focus
  • mental fatigue

These cognitive issues usually don’t progress to more severe forms such as dementia. But they can take a toll on your quality of life.

Managing lupus fog

If brain fog is affecting your day-to-day life, ask a doctor for a referral to a cognitive therapist. A cognitive therapist can help you learn ways to manage and cope with cognitive issues caused by lupus.

You may need to adjust your lifestyle and find ways to work around the cognitive problems until your lupus symptoms are under control. For example, you can set reminders on your phone or break up tasks to avoid having too much to do at once.

Inflammation and injury in the blood vessels of the brain caused by lupus can also lead to severe headaches. These are sometimes called “lupus headaches.”

The most common type of headache reported in people with lupus is migraine. Symptoms of a migraine headache include:

Managing lupus headaches

You can sometimes prevent a migraine episode by identifying what triggers the attack and then avoiding those triggers. A doctor may also prescribe medications to treat or prevent migraine headaches, such as pain relievers or triptans.

A mood disorder, such as depression, is the second most common symptom reported in people with NPSLE after headaches, according to a review of 22 studies that included more than 6,000 people with SLE.

Symptoms of depression often include:

  • feeling sad, hopeless, or worthless
  • loss of interest in activities or pastimes you once enjoyed
  • decreased energy or fatigue
  • difficulty sleeping

Researchers aren’t clear exactly how lupus causes depression and other mood disorders. They think these symptoms could result from damage to the nervous system or the presence of inflammatory cytokines — signaling molecules released by immune cells.

Keep in mind that some of the treatments used for lupus, such as corticosteroids, can also cause mood changes.

Treating mood disorders in lupus

Treatment for mood disorders may involve a combination of therapy, medications, and lifestyle changes, including:

Lupus can cause damage to your nerve cells and injury to blood vessels in your brain, along with inflammation in the nervous system. This can lead to a serious condition known as a seizure.

Seizures are changes in your brain’s electrical activity that can cause violent shaking and a loss of body control.

Seizures can happen to anyone with lupus but are more common in African American women. In one study of 368 people with SLE, 12.5% of participants reported having at least one seizure.

Managing seizures in lupus

If you’re having seizures, your doctor might prescribe an antiseizure medication (antiepileptic) to help prevent more seizures from happening. Research is ongoing to help understand the exact mechanism by which lupus causes seizures in hopes of developing new treatments.

With lupus, your body’s immune system mistakenly attacks your own organs and tissues. This immune system response can also increase your risk of blood clots. About 30% to 40% of people with lupus also have antiphospholipid syndrome, which can cause blood clots.

A stroke can occur if one of these blood clots travels to your brain and blocks its blood supply.

Symptoms of a stroke can come on suddenly. They include:

  • weakness in your arms, face, and leg, often on one side of the body
  • confusion or disorientation
  • slurred speech
  • paralysis
  • loss of balance
  • dizziness
  • vision problems

Treating stroke

A stroke is considered a medical emergency. If you think you or someone else is having a stroke, call 911 or your local emergency services right away.

Doctors often treat stroke with thrombolytic drugs to break up blood clots and blood thinners to prevent more clots from forming. You may also need physical, speech, and cognitive therapy to recover from a stroke.

A doctor may prescribe medications to help lower your risk of stroke in the first place. They may prescribe antiplatelet agents, such as aspirin, or blood thinners, such as heparin or warfarin.

You’re also at higher risk of stroke if you have high blood pressure (hypertension) or high lipid levels (hyperlipidemia). A doctor may prescribe medications to help you lower those levels.

Fibromyalgia is a chronic pain disorder that can occur alongside lupus. More than 20% of people with lupus also have fibromyalgia. Experts don’t know what causes fibromyalgia, but they think it may be related to changes in the sensors for pain within your brain.

Symptoms of fibromyalgia include:

  • chronic pain
  • tenderness
  • fatigue
  • irritable bowels
  • trouble sleeping

Treating fibromyalgia

There’s no cure for fibromyalgia. Pain medications, antidepressants, and antiseizure medications can help manage your symptoms.

Talk with a doctor if you have both lupus and fibromyalgia. Though the two conditions are related, treatment for each may differ.

Lupus can cause inflammation and damage to your nerves or the tissue around your nerves.

A condition called peripheral neuropathy can occur if lupus damages the nerves that connect your brain to the rest of your body, such as your arms and legs.

The main symptoms of peripheral neuropathy are numbness, tingling sensations (“pins and needles”), and muscle weakness.

Other symptoms include:

  • burning pain
  • reduced sensations of hot and cold
  • feeling intense pain from things that shouldn’t normally cause pain, such as light touch (allodynia)
  • drooping face and eyelids
  • dizziness
  • paralysis

Managing peripheral neuropathy in lupus

You can manage peripheral neuropathy with over-the-counter pain medications such as acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen.

If you experience a flare up of lupus symptoms, your doctor might prescribe a corticosteroid or another type of immunosuppressant to lower your body’s immune response.

We often think of the nervous system as involving our brain and spine (central) or nerves throughout our body (peripheral). But your autonomic nervous system (ANS) plays a key role in regulating your breathing, heart rate, and digestion, among other things.

When lupus affects your ANS, it could cause any of the following:

Orthostatic hypotension

Orthostatic hypotension is a sudden drop in blood pressure when you stand up. It can cause dizziness, lightheadedness, and blurred vision.


Tachycardia is an increased heart rate. In fact, changes in your heart rate are among the most common symptoms of lupus.

Treatment may include antiarrhythmic drugs or an implantable cardioverter defibrillator to regulate your heart rate.

Gastrointestinal (GI) problems

Your ANS also plays a role in regulating your GI system. Lupus can slow down your GI system, causing:

  • abdominal pain
  • nausea
  • vomiting
  • constipation

Some lupus medications may also contribute to these problems.


Between 36% and 86% of people with lupus experience fever. This is often due to an infection, but it could also be due to the effect of lupus on your ANS. Your hypothalamus, the control center of your ANS, helps to control your body temperature.

Even without an infection, people with lupus can have a peak body temperature as high as 40.6ºC (105.1ºF). If an infection isn’t the cause, you can usually treat a lupus fever with NSAIDs or acetaminophen.

If lupus affects your nervous system, it can cause mild symptoms such as:

  • headaches
  • tingling sensations
  • numbness
  • pain
  • fever

It can also cause more severe symptoms such as seizures or stroke or mood disorders such as depression.

Like other symptoms of lupus, these symptoms can vary greatly from person to person. It can also be difficult to tell if these symptoms are due to lupus, other conditions, or a result of medications you’re taking.

Your doctor may refer you to a specialist, such as a rheumatologist, neurologist, or psychiatrist, to see if your nervous system problems are related to lupus. These doctors will work together to find a treatment plan that helps you manage your symptoms.