Reversible parkinsonism in systemic lupus erythematosus

J Neurol Sci. 2001 Dec 15;193(1):53-7. doi: 10.1016/s0022-510x(01)00604-9.

Abstract

Parkinsonism as a manifestation of central nervous system (CNS) lupus is extremely rare. We report the first patient with systemic lupus erythematosus (SLE) who developed a reversible parkinsonian syndrome associated with enhancing subcortical lesions on magnetic resonance imaging (MRI). Following treatment with prednisolone and cyclophosphamide, her bradyphrenia, bradykinesia, hypophonia, rigidity, and abnormal gait progressively improved. Three months after she commenced treatment, repeat MRI scanning demonstrated resolution of the abnormal subcortical white matter enhancement. Our case illustrates unusual clinico-radiologic correlates of reversible parkinsonism in a SLE patient; these findings suggest that disruption of the subcortical frontal pathways may be a possible pathophysiologic mechanism for parkinsonism in cerebral lupus.

Publication types

  • Case Reports

MeSH terms

  • Brain / pathology*
  • Brain / physiopathology
  • Cyclophosphamide / therapeutic use
  • Female
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Lupus Vasculitis, Central Nervous System / drug therapy
  • Lupus Vasculitis, Central Nervous System / pathology*
  • Magnetic Resonance Imaging
  • Middle Aged
  • Parkinsonian Disorders / drug therapy
  • Parkinsonian Disorders / pathology*
  • Prednisolone / therapeutic use
  • Treatment Outcome

Substances

  • Immunosuppressive Agents
  • Cyclophosphamide
  • Prednisolone