Cerebellar ataxia as a primary manifestation of neuropsychiatric systemic lupus erythematosus

Abstract

Acute cerebellar ataxia is a rare primary manifestation of neuropsychiatric systemic lupus erythematosus (NPSLE). We report a case of a 22-year-old woman who presented with gait instability, behavioural changes and new-onset seizures. The tempo of disease progression was explained by an autoimmune cause, eventually fulfilling the criteria for systemic lupus erythematosus. The patient's neurological symptoms improved markedly following administration of steroids and immunomodulators. A review of literature on cerebellar ataxia in NPSLE and a summary of all reported cases to date are also presented.

Keywords: brain stem / cerebellum; epilepsy and seizures; neurology; rheumatology; systemic lupus erythematosus.

Figure 1

Electroencephalogram findings of a 22-year-old woman with (A) frequent polysharps occurring in runs in both the frontal and centrotemporal regions lasting for 7–10 s. (B) Jerking motion of the right leg was recorded associated with polysharps in the left frontotemporal region lasting for 1–2 s. (C) During and immediately after hyperventilation, there were runs of polysharps in the left frontocentrotemporal and right frontotemporal regions.