A 28-year-old woman with systemic lupus erythematosus (SLE) suffered recent onset fever, headache, encephalopathy followed by severe, repeated generalized seizures. Investigations revealed limbic encephalitis. Tests for Herpes simplex encephalitis and paraneoplastic encephalomyelitis were negative. High titers anti-ribosomal-P antibodies in the cerebrospinal fluid (CSF) suggested an association with nervous system lupus. No brain biopsy was performed. Treatment was with anti-seizure, anti-viral, and immunomodulating medication.
Alamowitch S et al. Limbic encephalitis and small cell lung cancer. Clinical and immunological features . Brain1997; 120: 923–928 .
2.
Cinque P et al. The role of laboratory investigation in the diagnosis and management of patients with suspected herpes simplex encephalitis: a consensus report . J Neurol Neurosurg Psychiatry1996; 61: 339–345 .
3.
Nadeau SE , Watson RT . Neurologic manifestations of vasculitis and collagen vascular syndromes. In: Baker AB, Baker LH (eds.) Clinical Neurology . Hagerstown: Harper and Row, 1979; 4. 1–133 .
4.
Denburg JA et al. Nervous system lupus: pathogenesis and rationale for treatment . Scan J Rheumatol1995; 24: 263–273 .
5.
Bonfa E et al. Association between lupus psychosis and anti-ribosomal P protein antibodies . N Engl J Med1987; 317: 265–271 .
6.
Koren E et al. Autoantibodies to the ribosomal-P proteins react with a plasma membrane-related target on human cells . J Clin Invest1992; 89: 1236–1241 .
7.
Gaburo N et al. In vivo effects of anti-ribosomal-P protein antibody injections into the lateral ventricle of the rat brain . Arthritis Rheum1995; 38: S297-S297 .
8.
Sibbitt WL et al. Spin-spin relaxation of brain tissues in systemic lupus erythematosus . Arthritis Rheum1995; 38: 810–818 .
9.
Stübgen J-P . Crossed cerebellar diaschisis related to recurrent focal seizures . Epilepsia1995; 36: 316–318 .
10.
Rothman SM , Olney JW . Excitotoxicity and the NMDA receptor . Trends Neurosci1987; 10: 299–302 .
