A nervous system involvement is common in systemic lupus erythematosus, and may be the initial manifestation of the disease. The spectrum of nervous system involvement is wide, and encompasses almost the whole range of neurological diseases. The neurological lupus is divided into a primary and a secondary group, and in the latter the pathogenetic role is supported by drugs and by organic and functional changes in the other organs and systems. In secondary neurological lupus, when a clinical picture of a focal cerebral injury is sustained by the presence of lupus anticoagulants, the prognosis is strict and the treatment problematic. Finally, among the primary neurological lupus it is important to distinguish two subsets of acute and subacute neurological lupus, because of differences in its management and prognosis.
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