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CNS involvement occurs in 30 to 60% of patients with systemic lupus erythematosus (SLE). Cognitive dysfunction is the most common manifestation.1 Movement disorders are a rare manifestation of CNS lupus, the most frequently described being chorea. Parkinsonism as a manifestation of CNS lupus is extremely rare.2 In previous brain SPECT reports, SLE-related parkinsonism was associated with decreased basal ganglia perfusion.2,3⇓ Here, we describe reversible parkinsonism in a patient with CNS lupus, who showed increased basal ganglia perfusion on SPECT with a dramatic response to levodopa.
Patient.
A 43-year-old woman was admitted because of fever, headache, and dizziness. At the age of 36, she had been diagnosed with SLE based on migratory arthralgia, skin rash, and elevated antinuclear and anti-DNA antibody titers. After steroid pulse therapy, she showed clinical and serologic improvements. Since then, she had been free of active disease on a maintenance dose of prednisolone. After admission, oral prednisolone (60 mg/day) was started. On the …
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