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A case report of dysphagia and cervical muscle weakness along with predominant bulbar palsy as the initial presentation of systemic lupus erythematosus
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Mehrdokht Mazdeh *   , Mojtaba Khazaei |
| Hamadan U. niversity of Medical Sciences , mehrdokhtmazdeh@yahoo.com |
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Abstract: (7732 Views) |
Background: Neuropsychiatric disorders are among the known complications of systemic lupus erythematosus (SLE). The involvement of both peripheral and central nervous systems has also been reported in SLE.
Case Report: A 32 year-old woman presented with 15 days history of progressive dysphagia, the nasal intonation of voice with no significant previous medical illness. The neurologic examination showed a marked bulbar (involvement of 9, 10, 11 cranial nerves) and cervical palsy. Other systemic examinations were normal. Hematologic tests, ESR, CRP, renal and hepatic tests and a chest x-ray PA were normal. Moreover, the CSF analysis and electrophysiological studies (EMG, NCV) were normal. The ANA and Anti-ds DNA tests were positive for two consecutive times. Brain MRI revealed infarct lesions in RT cerebellar hemisphere and dorsal brainstem. A diagnosis of vasculitis secondary to liked-lupus was made based on laboratory tests and imaging. Then intravenous immunoglobulins (0.4 g/kg/day) and 0.5 g methyl prednisolone for 5 days were administered. She was discharged for the rheumatologic follow-up.
Conclusion: It can be concluded that SLE should be considered in any patient with obscure neurological problems. |
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| Keywords: Deglutition disorders, Vasculitis, Progressive bulbar palsy, Systemic lupus erythematous |
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Full-Text [PDF 153 kb]
(2861 Downloads)
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Type of Study: Case Report |
Subject:
medicine, paraclinic
Received: 2014/10/18 | Revised: 2014/10/29 | Accepted: 2014/10/18 | Published: 2014/10/18
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