Can Lupus Cause Seizures? The Link Between Lupus and Seizures Explained

Can Lupus Cause Seizures?

Lupus is an autoimmune disease that can affect multiple parts of the body. One of the more serious potential complications of lupus is seizures and epilepsy. Let's take a closer look at the link between lupus and seizures.

What is Lupus?

Lupus is an autoimmune disease where the immune system mistakenly attacks healthy tissue and organs in the body. This can lead to widespread inflammation and a wide variety of signs and symptoms. The most common type of lupus is systemic lupus erythematosus (SLE). Some of the key facts about lupus include:

• Much more common in women than men
• Often starts between ages 15-44
• The cause is unknown but both genetics and environment play a role
• Can affect many parts of the body including joints, skin, kidneys, heart, lungs, blood vessels, and brain
• No cure but treatment focuses on managing symptoms

How Might Lupus Lead to Seizures?

There are a few different ways that lupus may increase the risk of seizures:

• Lupus brain inflammation: Lupus can cause inflammation in the brain, which could irritate nerves and make seizures more likely.
• Blood clots: Lupus increases the risk of blood clots, which could cause seizures if a clot blocks blood flow to the brain.
• Medications: Some medications used to treat lupus, like immunosuppressants, can lower the seizure threshold.
• Kidney disease: Lupus kidney disease can cause fluid/electrolyte imbalances that could contribute to seizures.
• Vasculitis: Lupus-related vasculitis (inflammation of blood vessels) could lead to brain bleeding and seizures.
• Antibodies: It is possible that autoantibodies in lupus could directly attack nerve cells or brain tissue and trigger seizures.

What Percentage of Lupus Patients Have Seizures?

Estimates vary, but studies have found that seizures or epilepsy occur in 10-20% of people with lupus. The risk seems highest for those with active lupus brain inflammation or kidney disease. Seizures also tend to be more common early in the disease course when lupus activity is at its peak.

Types of Seizures in Lupus Patients

There are many different types of seizures. Some more general categories of seizures that may occur with lupus include:

• Generalized seizures: Seizures that involve the entire brain at once. This includes grand mal seizures with muscle stiffening and jerking.
• Focal seizures: Seizures that originate in and affect just one area of the brain. Can be aware or impaired awareness.
• Status epilepticus: Continuous seizure activity lasting more than 5 minutes or recurrent seizures without regaining consciousness.
• Febrile seizures: Seizures triggered by having a fever, which lupus patients may be prone to.

What Are the Symptoms of Lupus Seizures?

The symptoms of seizures in lupus patients are similar to seizures with other underlying causes. This may include:

• Sudden loss of consciousness
• Staring blankly
• Uncontrollable jerking movements
• Stiffening and twitching of muscles
• Falling down suddenly
• Temporary confusion after the seizure
• Loss of bowel/bladder control
• Biting the tongue

Focal aware seizures may cause subjective sensations like fear, anxiety, deja vu, or unusual smells or tastes. Seizures are typically 1-3 minutes but status epilepticus is a medical emergency.

When to See a Doctor

It's always important to see a doctor after a first seizure or any change in seizure pattern. For someone with lupus, new seizures could represent a lupus flare or a serious complication that needs prompt attention. Seek emergency care for:

• Seizure lasting more than 3-5 minutes
• Recurring seizures without regaining consciousness
• Injury or fall during seizure
• Difficulty breathing after seizure
• Confusion, headache, weakness or vision changes after seizure

Lupus Seizure Diagnosis and Testing

To determine the cause of seizures, the doctor may order tests like:

• Blood tests to look for autoantibodies, electrolyte imbalances
• Urine test for protein or blood
• MRI of the brain to look for inflammation
• CT scan to check for bleeding
• EEG to assess seizure activity
• Possibly a spinal tap or biopsy if needed

Treating Seizures in Lupus Patients

Treatment focuses on preventing further seizures from occurring with anti-seizure medications like:

• Carbamazepine
• Levetiracetam
• Lamotrigine
• Valproic acid
• Phenytoin
• Topiramate

If lupus inflammation seems to be contributing to seizures, high dose steroids or immunosuppressants may help. Treating high blood pressure, kidney disease and avoiding triggers like sleep deprivation or flashing lights may also be beneficial.

What Is the Prognosis for Lupus Patients with Seizures?

The prognosis for lupus seizures varies considerably. Many patients respond very well to anti-seizure medication and do not have recurrences. However, seizures can be difficult to control in some patients, especially if there is active lupus affecting the central nervous system. This may require more intensive immunosuppression to prevent further lupus flares.

Can Seizures Cause Permanent Damage in Lupus?

Frequent recurrent seizures can potentially lead to permanent issues like:

• Damage to nerve cells
• Memory and thinking problems
• Motor deficits
• Speech impairment

Seizures can also cause accidental injuries. This is why it is so important to control seizures and limit recurrence. With prompt treatment, many patients do very well and seizures do not lead to long term impairment.

Lifestyle Changes to Reduce Lupus Seizure Risk

Steps lupus patients can take to lower seizure risk include:

• Carefully following the treatment plan
• Monitoring for lupus flares
• Getting enough sleep and avoiding fatigue
• Staying hydrated and controlling electrolytes
• Avoiding drugs that lower seizure threshold
• Minimizing stress
• Avoiding events like sleep deprivation or flashing lights that can be seizure triggers

Some level of seizures may be unavoidable in lupus. But keeping the disease well-controlled and brain inflammation minimal can go a long way in reducing risk.

The Bottom Line...

Seizures and epilepsy are an associated condition that occurs in a significant subset of lupus patients. Several different lupus-related factors can make seizures more likely to occur. Diagnosing and promptly treating seizures is critical to prevent recurrence and potential permanent damage. With proper treatment and lifestyle changes, seizures can often be well-managed.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.