Skip to main content Accessibility help
  • Get access
    Check if you have access via personal or institutional login
  • Cited by 1
  • Print publication year: 2011
  • Online publication date: March 2012

Chapter 82 - Systemic lupus erythematosus and other collagen vascular diseases

from Section 3 - Symptomatic epilepsy


Gliomas are neoplasms derived from glial cell precursors. Gliomas may present with one or a combination of neurological deficits, symptoms of mass effect and seizures, usually reflecting the anatomical location of the lesion. Seizures in the context of glioma appear to confer a significant prognostic benefit. Epileptic foci are believed to develop within the cortex surrounding tumors, since the lesions themselves have no electroencephalographic (EEG) activity and are not electrically excitable. Diagnosis of a space-occupying lesion as the cause of a seizure is made usually with the aid of cross-sectional imaging. Magnetic resonance imaging (MRI), with and without gadolinium contrast, is the investigation of choice, showing a higher sensitivity and specificity than computed tomography (CT) for detecting glioma. Fractionated focal radiotherapy is a key component of adjuvant treatment, especially in high-grade lesions. Chemotherapy with temozolomide has been shown to be of seizure benefit in approximately 50% of Grade 2 gliomas.


Appenzeller S, Cendes F, Costallat LT (2004) Epileptic seizures in systemic lupus erythematosus. Neurology 63:1808–12.
Avcin T, Benseler S, Tyrrell P, Cucnik S, Silverman E (2008) A follow-up study of antiphospholipid antibodies and associated neuropsychiatric manifestations in 137 children with systemic lupus erythematosus. Arthritis Rheum 59:206–13.
Baca V, Lavalle C, García R, et al. (1999) Favorable response to intravenous methylprednisolone and cyclophosphamide in children with severe neuropsychiatric lupus. J Rheumatol 26:432–9.
Bautista JF, Kelly JA, Harley JB, Gray-McGuire C (2008) Addressing genetic heterogeneity in complex disease: finding seizure genes in systemic lupus erythematosus. Epilepsia 49:527–30.
Benseler SM, Silverman ED (2007) Neuropsychiatric involvement in pediatric systemic lupus erythematosus. Lupus 16:564–71.
Brey RL (2007) Neuropsychiatric lupus. Bull NYU Hosp Jt Dis 65:194–9.
Chien-Liang C, Yee-Hsuan C, Chan-Yao W, Ping-Hong L, Hsiao-Min C (2000) Cerebral vasculitis in Henoch–Schoenlein purpura: a case report with sequential magnetic resonance imaging changes and treated with plasmapheresis alone. Pediatr Nephrol 15:276–8.
Cimaz R, Meroni PL, Shoenfeld Y (2006) Epilepsy as part of systemic lupus erythematosus and systemic antiphosphoplipid syndrome (Hughe syndrome). Lupus 15:191–7.
Cimaz R, Guerrini R (2008) Epilepsy in lupus. Lupus 17:777–9.
Futrell N, Schultz LR, Millikan C (1992) Central nervous system disease in patients with systemic lupus erythematosus. Neurology 42:1649–57.
González-Duarte A, Cantú-Brito CG, Ruano-Calderón L, Garcia-Ramos G (2008) Clinical description of seizures in patients with systemic lupus erythematosus. Eur Neurol 59:320–3.
Herranz MT, Rivier G, Khamashta MA, Blaser KU, Hughes GR (1994) Association between antiphospholipid antibodies and epilepsy in patients with systemic lupus erythematosus. Arthritis Rheum 37:568–71.
Jaques-Spinosa M, Bandeira M, Noronha Liberalesso PB, et al. (2007) Clinical, laboratory and neuroimage findings in juvenile systemic lupus erythematosus presenting involvement of the nervous system. Arq Neuropsiquiatr 65:433–9.
Kister I, Inglese M, Laxer RM, Herbert J (2008) Neurologic manifestations of localized scleroderma: a case report and literature review. Neurology 71:1538–45.
Koppel BS (2008) Connective tissue diseases. In: Engel J Jr. and Pedley TA (eds.) Epilepsy: A Comprehensive Textbook. Philadelphia, PA: Lippincott Williams and Wilkins, pp. 2653–60.
Mikdashi J, Krumholz A, Handwerger B (2005) Factors at diagnosis predict subsequent occurrence of seizures in systemic lupus erythematosus. Neurology 64:2102–7.
Olfat MO, Al-Mayouf SM, Muzaffer MA (2004) Pattern of neuropsychiatric manifestations and outcome in juvenile systemic lupus erythematosus. Clin Rheumatol 23:395–9.
Quintero del Rio AI (2000) Neurologic symptoms in children with systemic lupus erythematosus. J Child Neurol 15:803–7.
Ranua J, Luoma K, Peltola J, et al. (2004) Anticardiolipin and antinuclear antibodies in epilepsy: a population-based cross-sectional study. Epilepsy Res 58:13–18.
Rood MJ, ten Cate R, van Suijlekom-Smit LWA, et al. (1999) Childhood-onset systemic lupus erythematosus. Scand J Rheumatol 28:222–6.
Sanna G, Bertolaccini ML, Cuadrado MJ, et al. (2003) Neuropsychiatric manifestations in systermic lupus erythematosus: prevalence and association with antiphospholipid antibodies. J Rheumatol 30:985–92.
Shoenfeld Y, Lev S, Blatt I, et al. (2004) Features associated with epilepsy in the antiphospholipid syndrome. J Rheumatol 31:1344–8.
Spinosa MJ, Bandeira M, Liberalesso PB, et al. (2007) Clinical laboratory and neuroimage findings in juvenile systemic lupus erythematosus presenting involvement of the central nervous system. Arg Neuropsiquiatr 65:433–9.
Tabarki B, Mahdhaoui A, Selmi H, Yacoub M, Essoussi AS (2001) Kawasaki disease with predominant central nervous system involvement. Pediatr Neurol 25:239–41.
Toubi E, Khamashta MA, Panarra A, Hughes GR (1995) Association of antiphospholipid antibodies with central nervous system disease in systemic lupus erythematosus. Am J Med 99:397–401.
Von Scheven E, Lee C, Berg BO (1998) Pediatric Wegener's granulomatosis complicated by central nervous system vasculitis. Pediatr Neurol 19:317–19.
West SG, Emlen W, Wener MH, Kotzin BL (1995) Neuropsychiatric lupus erythematosus: a 10-year prospective study on the value of diagnostic tests. Am J Med 99:153–63.
Yancey CL, Doughty RA, Athreya BH (1981) Central nervous system involvement in childhood systemic lupus erythematosus. Arthritis Rheum 24:1389–95.
Yu H-H, Lee J-H, Wang L-C, Yang Y-H, Chiang B-L (2006) Neuropsychiatric manifestations in pediatric systemic lupus erthematosus: a 20-year study. Lupus 16:651–7.
Zulian F, Vallongo C, Woo P, et al. (2005) Localized scleroderma in childhood is not just a skin disease. Arthritis Rheum 52:2873–81.