Lupus and the Nervous System  

Lupus causes the immune system, which is designed to attack foreign invaders, to attack the healthy tissues of the body. The result is often damage to organs and systems that are otherwise healthy.

How lupus affects the nervous system

The nervous system is one of many that can be negatively impacted by lupus. The nervous system is comprised of the brain, spinal cord, nerves, and sensory organs, and is responsible for the coordination of bodily functions. It’s comprised of three parts:

• the central nervous system (CNS) controls bodily function
• the peripheral nervous system (PNS) communicates between the CNS and the rest of the body
• the autonomic nervous system regulates involuntary body processes like breathing

When lupus creates inflammation in the nervous system, all 3 parts can be affected: the central nervous system, the autonomic nervous system, and the peripheral nervous system. Because the nervous system has a role in every aspect of bodily function, the signs and symptoms of nervous system involvement in lupus are many.

Lupus and the central nervous system

When lupus attacks the central nervous system, cognitive dysfunction is very common. You may feel disorganized, have trouble remembering important information, experience fatigue, or have difficulty putting your thoughts into words. In the lupus world, this is often called lupus fog.

Steps you can take to reduce the impact of cognitive symptoms of lupus on your daily life:

• develop systems that help you stay organized and on top of commitments, like a daily planner and alarms on your phone
• work on games and puzzles that challenge you cognitively, like sudoku puzzles, crossword puzzles, or smartphone apps like the Elevate app
• keep stress at a minimum but avoiding over-scheduling yourself and working through stressful events as they occur, with the help of a mental health professional if necessary and helpful

A surprising half of all people who have mild to moderate lupus experience lupus fog, so finding healthy ways to limit the impact and cope with the inconvenience can dramatically improve quality of life.

Additionally, lupus impacts the CNS by causing headaches. These headaches can be caused by an overlapping condition called Reynaud’s phenomenon or by vasculitis, inflammation of blood vessels in the brain, or other parts of the body. The symptoms might mimic migraine symptoms. Most patients are able to control their lupus headaches using over-the-counter headache medications, but if you’ve tried OTC medications without luck, consult your doctor to explore other treatment options.

Lupus and the autonomic nervous system

Your autonomic nervous system regulates involuntary processes like your blood pressure, body temperature, sweating, breathing, and heart rate, to name a few. When your immune system attacks your ANS, you might experience a wide range of symptoms that don’t seem to related to one another (or to your lupus, in many cases). Those symptoms include numbness, tingling, burning, headaches, confusion, diarrhea, and Reynaud’s phenomenon. Reynaud’s phenomenon is the excessive constriction of blood vessels (and subsequent restriction of blood flow) in response to cold exposure.

Lupus and the peripheral nervous system

The peripheral nervous system is comprised of all of the nerves outside the brain and spinal cord. Lupus can lead to inflammation of these nerves and inflammation of the tissue surrounding the nerves, leading to pinching and pressure.

If you’re experiencing carpal tunnel syndrome, problems with your eyesight, tinnitus (ringing in your ears), pain or numbness in your face, drooping, or dizziness, it’s like you have an inflamed or compressed nerve. This can be related to a lupus flare-up, so it’s important to let your doctor know right away so they can take appropriate action to protect your vital organs.

Side effects of lupus medications

Adding complexity to the diagnosis of lupus-related nervous system dysfunction is the fact that medications often used to treat lupus are accompanied by side effects that might mimic nervous system involvement. As your provider works to better understand the impact of lupus on your body, he or she will take into consideration the medications you’ve been prescribed and the most likely side effects of those medications. Sometimes a simple med change can alleviate symptoms that mimic the nervous system involvement of lupus.

In fact, nearly all of the medications used to manage lupus can create nervous system side effects. For example, NSAIDs can cause dizziness, confusion, and headache, and corticosteroids can lead to psychosis, confusion, aggressiveness, and depression. Ruling out medication-related side effects is an important step in understanding and treating the cause of any neurological deficits.

Diagnosing lupus-related nervous system conditions

Diagnosing lupus-related problems with the nervous system can be challenging because the symptoms might be indicative of other diseases or conditions. Lupus patients experiencing cognitive or other nervous system symptoms will likely need to consult with a neurologist, who specializes in diagnosing and treating these conditions. They may order a range of tasks depending on the presentation, including behavior tests, cognitive tests, x-rays, brain scans, spinal tap, and electroencephalograms.

Keeping track of your symptoms is important for anybody who has lupus as it can serve as a tool for early detection of exacerbation or flare-ups and give your provider the opportunity to intervene before organ damage occurs.

Prevention of lupus-related nervous system impacts

You can help prevent lupus-related nervous system problems by:

• taking your medications as prescribed and following your treatment plan
• staying physically active and making good nutritional choices
• getting enough sleep
• working through stressful situations proactively with the help of a therapist or mental health professional
• tracking your symptoms and sharing any changes with your provider right away

Treatment of lupus-related nervous system dysfunction

In order to limit the impact of lupus on the nervous system, your provider will work to keep your immune system from issuing an attack on healthy tissues. For many patients, this requires the use of antimalarials like hydroxychloroquine or immunosuppressants. In some cases, steroids or corticosteroids might be prescribed to alleviate severe inflammation causing unwanted or dangerous symptoms.

The cognitive dysfunction that as many as half of all lupus patients experience is referred to as lupus fog and can be managed with lifestyle change. Maintaining a schedule that’s manageable, using a structured planner or system for organizing your day, and taking steps to exercise your brain regularly can help reduce the impact of lupus fog on your life.