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Task Force Report on Brain Involvement in Antiphospholipid Syndrome

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Abstract

Many neurological manifestations have been described in Antiphospholipid Syndrome (APS). More work is needed to identify those individuals with antiphospholipid antibodies (aPL) who are at greatest risk for nervous system manifestations. Antiphospholipid antibodies are established risk factors for a first ischemic stroke in patients with and without systemic lupus erythematosus (SLE), and recurrent cerebrovascular ischemia, particularly in adults with SLE; however, subgroups of these patients at high-risk for recurrent events have not been clearly identified. Persistently positive aPL are associated with cognitive dysfunction in adults with SLE. There is no evidence to support an association between aPL and headache. Antiphospholipid antibodies may be associated with a worse clinical course in adults with SLE who also have Multiple Sclerosis (MS) or an “MS-like” illness and anticardiolipin antibody IgM may be increased during an exacerbation in adults with definite MS, but without SLE. Antiphsopholipid antibodies are associated with seizures and epilepsy in patients with and without SLE. Particular attention needs to be paid to differentiating those manifestations that are mediated through a thrombotic mechanism and those that are mediated through another immune-mediated mechanism. Additional studies that help determine the pathophysiology of aPL-mediated nervous system effects are needed to target appropriate therapies.

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Author information

Authors and Affiliations

  1. Department of Neurology and Sagol Center for Neuroscience, Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel

    Joab Chapman MD

  2. Sections of Rheumatology and Neurology, Department of Pediatrics, Texas Children’s Hospital, Houston, TX, USA

    Eyal Muscal MD, MS

  3. Department of Neurology, University of Texas Health Science Center, 8300 Floyd Curl Drive, San Antonio, TX, 78229, USA

    Robin L. Brey MD

Authors
  1. Joab Chapman MD
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  2. Eyal Muscal MD, MS
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  3. Robin L. Brey MD
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Corresponding author

Correspondence to Robin L. Brey MD .

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Editors and Affiliations

  1. The Barbara Volcker Center for Women and Rheumatic Diseases, Hospital for Special Surgery, New York, NY, USA

    Doruk Erkan

  2. University of Texas Medical Branch, 301 University Boulevard, Galveston, 77555-0883, Texas, USA

    Silvia S. Pierangeli

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Chapman, J., Muscal, E., Brey, R.L. (2012). Task Force Report on Brain Involvement in Antiphospholipid Syndrome. In: Erkan, D., Pierangeli, S. (eds) Antiphospholipid Syndrome. Springer, Boston, MA. https://doi.org/10.1007/978-1-4614-3194-7_10

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  • DOI: https://doi.org/10.1007/978-1-4614-3194-7_10

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  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4614-3193-0

  • Online ISBN: 978-1-4614-3194-7

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