APPLICATION OF COMPLEX NEUROPSYCHOLOGICAL METHODS

Background: Affection of Central Nervous System (CNS) is identified among more than the half of patients with Systemic Lupus Erythematosus (SLE). As far as cerebrovasculitis is a serious, potentially disabling and unfavorably predicted form of SLE the importance of early application of available non-invasive methods of CNS complex examination becomes obvious.Objectives: Reveal the extent of CNS affection of patients with SLE on the basis of neurological, neuropsychological symptoms and trascranial dopplerography outcome analysis.Methods: 21 patients (20 women and 1 man) with proved SLE diagnosis were examined (according to ARA criteria, 1982). Average age of patients was 28.95 years (range 16-54), duration of the disease average 5.7 years (from 6 months to 20 years). The patients went through neuropsychological and transcranial dopplerography on "ANGIODIN" apparatus with 2, 4 and 8 MHz sensors in complex with common methods of examination.Results: 10/21 patients (47.6%) had distinct left hemisphere deviations. Neurological symptoms were characterized by right side pyramid insufficiency and were expressed by paresis of XII pairs of brain-cranium nerves by central type, bending-pronatoral phenomenon on the right with high tendon reflexes and pathological reflex of Babinski while 6/10 had fall of otokinetic nistagm to the right.Neuropsychological symptoms were represented by difficulties of performing probes for visual image pose praxis. They were notable at disautomatization of their sequence violation – insertion of motion elements, especially serial program. During examination of non-verbal hearing gnosis there were found some deviations in nomination of rhythmical structures at its relatively correct reproduction. Examination of audible-verbal memory of 4 patients from that group revealed certain defects, represented as lowering of vocabulary learning level. 3 patients had disorder of mental processes on the level of verbal-logical mode of thinking during solution of arithmetical tasks. Transcranial dopplerography revealed lowering of blood circulation linear speed for about 20% on the side of pathological process among all the 10 patients of that group. 7/12 SLE patients had distinct right hemisphere pathology. Neurological symptoms were characterized by left side pyramid insufficiency and fall of otokinetic nistagm to the left. Neurological tests for receiprok coordination revealed distinct aspontaneity of left hand, which fall off during the task. Examination of non-verbal hearing gnosis discovered deviations among the majority 6/7 (85.7%) of patients of that group in part of affected genesis which were indicated by wrong nomination and motoric reproduction defects. Examination of memory marked defects in remembering of simple programs, rhythms. Transcranial dopplerograghy revealed lowering of blood circulation linear speed for about 22-28% in right carotid basin among all patients of that group.Conclusion: Thus, majority of patients had distinct neurological, neuropsychological and dopplerographic deviations mainly corresponding to affection of certain hemisphere.Citation: , volume , supplement , year 2004, page Session: SLE – Clinical aspects