When you say your lupus is “getting on your nerves” you may be completely accurate. Sadly, Lupus can attack the nervous system as easily as it can attack your joints, skin or any other part of the body. People may experience many different manifestations of nervous system complications. It can affect everything from someone’s memory… to…where was I going with this? Oh that’s right, the nervous system. I forgot. It can affect someone’s memory, cause sensitivity to touch, and a bouquet of other colorful issues as well.
But before we breakdown the problems that may arise, let’s delve into the different areas that make up this amazing roadmap of communication called your nervous system. There are two main parts at work here: the Central Nervous System and the Peripheral Nervous System.
The Central Nervous System is made up of the brain and the spinal cord. The Central Nervous System controls almost all the functions of the mind and body. The brain contains around a hundred billion nerve cells or “neurons” and over a trillion support cells called “glia.” These neurons are working units in the brain that are designed to transmit information to other nerve cells, muscle, or gland cells. Neurons respond to touch, sound, light and all other stimuli affecting the cells. Glia act as transport cells that carry nutrients to neurons, clean up brain debris, help hold neurons in place and digest parts of dead neurons.
The Peripheral Nervous System consists of the remainder of nervous system and carries signals outside the brain and spinal cord to the rest of the body. These signals tell the muscles how to move and send pain sensations to the skin. The main function of the PNS is to connect the Central Nervous System (CNS) to the organs and extremities, serving as a communication transit system, going back and forth between the brain and the limbs. The PNS is broken down into two sections: the Somatic and the Autonomic nervous systems. The Somatic nervous system is associated with the voluntary control of body movements and skeletal muscle. While the Autonomic Nervous System connects the brain and internal organs (like the heart, lungs and various glands) and works primarily on its own.
SO…did I lose you? Talk about a lot of information for one sitting! Who knew that something as simple as blinking one’s eyes could have such a complicated internal process behind it! Now that we know the “behind the scenes” let’s get down to the main show. Below are some of the most common nervous system issues associated with lupus and ways that you can help the things that are getting “on your nerves.”
Cognitive dysfunction is the most common problem related to the CNS and lupus. This is generalized as cloudy thinking (lupus fog), memory loss/impairment and confusion. It is believed that 80 percent of lupus individuals who have had the disease for ten years or more will experience some facet of cognitive dysfunction. Scientists feel that this disruption is attributed to a decrease in oxygen delivery to certain parts of the brain. Sadly, there is no definitive treatment for these problems. Some individuals have found relief through cognitive therapy or medications to increase concentration. A diet high in fruits and vegetables, nuts and seeds (particularly walnuts), olive oil and turmeric may help cognitive function as well. Back to top
Around 20 percent of people with lupus will experience migraines. It is important to figure out what your migraine triggers are. UV lights, lack of sleep, food sensitivities, dehydration, stress, hormone changes, alcohol, weather changes and caffeine dependency are all common migraine triggers.
There are many different medications out there to help alleviate migraine symptoms. They are broken down into two different categories: preventative and abortive/acute. Preventative medications include: cardiovascular, beta-blocker drugs (like Propranolol), antidepressants (like Nortriptyline) and anti-seizure medications (like Topamax). Acute symptom relieving medications include: NSAIDS, triptans (Imitrex, Zomig), and ergots (caffeine combo drugs, like Migergot). It is important to discuss with your doctor what medication is right for you. Alternative therapies like acupuncture and yoga have been know to give some migraine sufferers relief as well. Back to top
Central nervous system (CNS) vasculitis involves inflammation of the blood vessels in the brain or spine. It usually occurs when abnormal antibodies attack the white blood cells, and the walls of the blood vessels become inflamed. Sometimes infections or virus can cause it as well. Symptoms of CNS vasculitis can be seizures, mental fuzziness or confusion, sensation abnormalities or even stroke. It is most often treated with high-dose steroids such as prednisone, in combination with immunosuppressants. Back to top
Fibromyalgia is known as a condition that is categorized by chronic widespread pain and heightened sensitivity to touch. This sensitivity appears to stem from a neurochemical imbalance with pain-processing. Many advances have been made in acknowledging the disease and the physical impacts it has on the individual. Anti-seizure medications like Lyrica have been introduced to help with pain management and studies have shown that regular exercise increases the body’s production of endorphins which are natural painkillers and mood boosters. For more information on fibromyalgia, read our blog here. Back to top
Organic Brain Syndrome
OBS is sometimes confused with dementia, but is a general term that describes a decreased mental function and state due to a medical condition. Brain injury from a trauma, breathing conditions, cardiovascular conditions, and degenerative disorders like Alzheimer’s or Multiple Sclerosis can cause OBS. Treatment depends on the origin of the problem. Supportive care and rehabilitation to assist where brain function is lost, as well as medications to reduce any behavioral issues may be helpful. Back to top
Central Nervous System Lupus
Lupus can cause an increase of inflammation in the body. Central Nervous System Lupus can be caused by such swelling. It is an illness that can be serious but treatable. It can range from mild cognitive dysfunction to major issues. Usually this type of lupus is diagnosed after a neurologic event i.e. stroke, seizure or coma. The standard treatment for the CNS Lupus is immunosuppression with corticosteroids and symptom management. Back to top
Tests and Diagnostics
Diagnosing various issues with the nervous system can be, like lupus itself, a complicated puzzle. Many of the symptoms overlap with other disorders.
Neurological tests like CAT scan, EEG, MRI, EMG, angiogram, neurosonography, myelography and spinal taps are used to evaluate individuals that are suspected of suffering from a neurological condition. Back to top
We know that occasionally, inflammation of the brain can lead to conditions like the ones listed above. However, with treatment and diagnostic advances people with neurological disorders associated with lupus can live well-balanced and long lives. Realizing the complexity of the nervous system should give you a new perspective that a million things go right a day for the possible one thing that may go wrong.
So, enjoy the things that go right. Life is too short to be “nervous” all the time. Back to top
Sources: emedicine.medscape.com/article/1146456, hopkinslupus.org/lupus-info/lupus-affects-body, healthline.com/health/migraine/triggers, changingminds.org/explanations/brain, merckmanuals.com/home/brain,-spinal-cord,-and-nerve-disorders/autonomic-nervous-system-disorders, healthyeating.sfgate.com/food-can-cognitive-function, nlm.nih.gov/medlineplus/ency/article/001401
Author: Kelli Roseta
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