الفهرس | Only 14 pages are availabe for public view |
Abstract SLE is a systemic disease with possible nervous system involvement,. EP are electrophysiological markers of disturbed CNS function, even in subclinical stage. The purpose of the study was to evaluate parameters of EP in the patients with SLE with or without neuropsychiatric manifestation . Our present study include 60 SLE cases 3 males and 57 female patient which were subdivided in to two groups NPSLE whether with CNS or PNS problem and non-NPSLE cases ,The study also include 30 person as a control group. At our present study we found that Parameters of VEP and BAEP and ERP show asymmetric abnormalities in SLE patients, regardless of manifest or non-manifest CNS abnormalities. Evoked potential can detect CNS abnormalities in subclinical stages giving chance for SLE patient for better treatment protocol and hence better prognosis. EP may be considered as a biomarkers of early CNS dysfunction in the course of SLE. Corticosteroid dose should be considered and evaluated ,as it causes evoked potential parameters abnormalities if in high doses causing neuropsychatric manifestations so if controlled these parameters return back to normal range not due to lupus pathology effect. Disease duration found not to have a relation to evoked potential parameters abnormalities suggesting that the pathology of CNS changes with lupus due to disease itself whether by autoantibody or vascular changes by SLE. Cognitive dysfunction is an important symptom and common in SLE patient can be detected in early subclinical stages using p300 giving patient better chance for early treatment before deterioration of CNS functions. At our present study we found many autoantibodies as a risk factor for evoked potential parameter abnormalities ,hence may be considered as a risk factor for developing neuropsychatric manifestations. A novel finding to our present study that anti-sm ab, antiCENP ab,anti polymerase III,anti histone ab,sm/RNP ab ,and anti RNP ab are suggested to be a risk factor for evoked potential parameter abnormalities,hence there presence may suggest CNS problem in SLE patients ,so needing good follow up before being manifest. Recommendations: • Further studies to detect future clinically manifest CNS dysfunction and other neurological events in Non-NPSLE cases with abnormal EP parameters and so, using VEP ,BAEP,ERP as a neurophysiological biomarkers for NPSLE. • Further studies are needed for patients with prolonged p100 latency and low amplitude to show effect of change treatment protocols for these patients as using more aggressve therapy as cyclophosphamide ,MMF, using vasodilator drugs and neuroprotective therapy if can regress optic neuritis by using follow up VEP. • Further prospective studies are recommended to show autoantibodies related to neuropsychatric problems in SLE using EP as objective method. |