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Psychology and Mental Health

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Manifestaciones neuropsiquiátricas en el lupus eritematoso sistémico

Author(s): Martínez VF, Ordi-Rios J, Vilardell-Tarrés M

Abstract

Las manifestaciones neuropsiquia´tricas del lupus eritematoso siste´mico (LES) incluyen los sı´ndromes neurolo´ gicos del sistema nervioso central (SNC), perife´ rico y autono´mico, ası´ como los sı´ndromes psiquia´tricos observados en los pacientes con LES, una vez que se han descartado otras causas de e´ stos. Actualmente, las manifestaciones neuropsiquia´tricas en los pacientes con LES continu´ an presentando dificultades importantes en el diagno´ stico y en el tratamiento de estos pacientes. Estas dificultades se deben en parte a la ausencia de especificidad de estas manifestaciones, por lo que ante la aparicio´n de una clı´nica neurolo´gica en un paciente con LES se debe establecer el diagno´ stico diferencial entre la propia enfermedad, una enfermedad infecciosa concomitante, la comorbilidad del paciente y el tratamiento administrado. En 1999 el ACR (American College of Rheumatology) formo´ un comite´ para crear una nomenclatura esta´ndar de las manifestaciones neuropsiquia´tricas del LES1 , definio´ 19 sı´ndromes clı´nicos para los que se desarrollaron criterios diagno´ sticos (tabla 1), y adapta la terminologı´a de la cuarta edicio´n del Manual diagno´ stico y estadı´stica de los trastornos mentales a los sı´ndromes neuropsiquia´tricos del LES para incluir la disfuncio´n cognitiva, el delirium (estado confusional agudo), el trastorno de ansiedad, el trastorno del humor y la psicosis.

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