We report, to the best of our knowledge, the first case of neuropsychiatric systemic lupus erythematosus with clinical presentation of bilateral upward gaze palsy and intraoral numbness. Magnetic resonance imaging of the brain was able to identify the pathogenic lesion at the left side of midbrain, involving the vertical gaze center and sensory pathways for innervating the buccal and hard palate mucosa. A course of aggressive immunosuppressive treatment resulted in prompt resolution of gaze palsy and the midbrain lesion.
GrootNGraeffNDAvcinT, et al.
European evidence-based recommendations for diagnosis and treatment of childhood-onset systemic lupus erythematosus: the SHARE initiative. Ann Rheum Dis2017;
76: 1788–1796.
8.
BertsiasGKIoannidisJPAAringerM, et al.
EULAR recommendations for the management of systemic lupus erythematosus with neuropsychiatric manifestations: report of a task force of the EULAR standing committee for clinical affairs. Ann Rheum Dis2010;
69: 2074–2082.
9.
FanouriakisAKostopoulouMAlunnoA, et al.
2019 Update of the EULAR recommendations for the management of systemic lupus erythematosus. Ann Rheum Dis2019;
78: 736–745.