Skip to content

Lupus Health Center

Care of the Lupus Patient

Font Size
A
A
A

Central Nervous System Manifestations continued...

Cranial or peripheral neuropathy occurs in 10-15% of patients; it is probably secondary to vasculitis in small arteries supplying nerves. Cerebrovascular accidents (strokes) are reported in approximately 15% of patients. Between 10 and 20% of patients experience seizures. Although cognitive impairment is believed to be very common, there are few measurements to document it.

Serious CNS involvement ranks behind only kidney disease and infection as a leading cause of death in lupus. However, the majority of SLE patients with CNS complications do not develop a life-threatening disease.

Potential Problems

  1. Alteration in mental status, cognition, and perception
  2. Altered ability to perform ADL and meet family responsibilities
  3. Potential for injury

Nursing Interventions

Objective: Develop Plan for Patient to Perform ADL Appropriately and Independently

Assess and document patient's mental status to determine her or his capabilities:

  • general appearance
  • unusual body movements
  • speech patterns and word use
  • alertness and orientation to time, place, and person
  • memory of remote and recent past
  • perception of self and environment
  • affect and emotional stability
  • ability to solve problems
  • presence of depression

Support patient's need to maintain some control over daily activities and decisions:

  • encourage patient to plan and participate in daily routines
  • set aside time to develop trust and rapport with patient, and be consistently truthful (patients are keenly aware of inconsistencies in information provided)

Potential CNS Manifestations

General CNS Lupus

  • Headaches
  • Fever
  • Confusion
  • Seizures
  • Psychosis

Cranial Neuropathies

  • Visual defects
  • Blindness
  • Nystagmus (involuntary movement of the eyeball)
  • Ptosis (paralytic drooping of the eyelid)
  • Papilledema (edema in the optic disk)
  • Tinnitus
  • Vertigo
  • Facial palsy

Cognitive Impairment

  • Confusion
  • Impaired long- and short-term memory
  • Difficulty in conceptualizing, abstracting, generalizing, organizing, and planning information for problem solving
  • Difficulties in personal and extrapersonal orientation
  • Altered visual-spatial abilities
  • Selective attention
  • Difficulties in pattern recognition, sound discrimination and analysis, and visual-motor integration

Mental Changes

  • Depression
  • Anxiety
  • Affective disorder
  • Mood swings
  • Hypomania or mania (especially with corticosteroid use)

Rare CNS Manifestations

  • Movement disorder
  • Aphasia
  • Coma

Encourage patient to discuss effects of SLE on her or his personal life and coping methods. Allow expressions of fear and anger.

1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | 14 | 15 | 16

Today on WebMD

grocery shopping list
And the memory problems that may come with it.
Lupus rash on nails
A detailed, visual guide.
 
sunburst filtering through leaves
You might be extra sensitive to UV light. Read on.
fruit drinks
For better focus in your life.
 
Woman rubbing shoulder
Slideshow
Bag of cosmetics
Video
 
young woman hiding face
Quiz
pregnant woman
Article
 
5 Lupus Risk Factors
Article
Young adult couple
Article
 
doctor advising patient
Article
sticky notes on face
Video
 

WebMD Special Sections