Rheumatologic Disease Initially Look Like Neurological Disorders

Lupus and other rheumatologic diseases initially appear as neurological disorders like headaches and seizures, eventually causing a delay in diagnosis.

In an autoimmune disease, the body's immune system attacks its own tissues and organs. The immune system becomes hyperactive. Lupus can trigger heart problems that lead to stroke and over half of the lupus patients suffer from headaches and a third of them suffer from migraine.

Nearly 1.5 percent of them have lupus headaches - a persistent, severe and intractable headache - which does not respond to narcotic medications. Almost 20 percent of the patients experience seizures and a third experience cognitive dysfunction. It is estimated that 20 percent of the lupus patients suffer from mood disorders as well. Most often lupus psychosis that includes paranoia and hearing voices is confused with schizophrenia.

Researchers at the Loyola University Medical Center found that rheumatologic disease like lupus initially looks like neurological disorders that can delay diagnosis for many months. Rheumatologic disease consists of autoimmune and inflammatory disorders of the joints and soft tissues like lupus, systemic vasculitis and ankylosing spondylosis.

"Moreover, treatments for rheumatologic disorders can cause adverse neurological effects," said Dr. Sean Ruland.

Those with systemic vasculitis have neurological disorders like headaches, seizures, stroke-like syndromes and optic neuropathies. A third of them suffer from residual neurological impairment and will need long term requirement to suppress their immune system.

Headaches, cerebellar and brainstem dysfunction, cognitive impairments, seizures and cranial neuropathy are some of the symptoms experienced by those with ankylosing spondylosis.

"Rheumatic disorders presenting as neurological syndromes may pose diagnostic challenges," Ruland and colleagues wrote. "However, these treatments also carry a risk of adverse neurological effects. Therefore, familiarity with neurological manifestations of rheumatologic diseases, diagnosis and potential nervous system consequences of treatment is paramount."

The finding is documented in journal Current Neurology and Neuroscience Reports.