What lupus is, and why the brain is on the list.
Systemic lupus erythematosus — usually shortened to lupus — is a chronic autoimmune disease. The immune system, which normally defends you against infection, turns on your own tissues instead. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), the inflammation that follows can be widespread, reaching the skin, joints, heart, lungs, kidneys, circulating blood cells, and the brain.
That last item is the reason this guide exists. The brain is not an unusual outlier in lupus; NIAMS names it among the organs the disease can inflame. When people are surprised by their own cognitive symptoms, it is often because lupus was described to them only in terms of rashes and sore joints.
The neurological symptoms people describe.
NIAMS lists headaches, dizziness, depression, confusion, and seizures among the symptoms lupus can produce, and specifically attributes seizures and memory problems to changes in the brain and central nervous system. The CDC separately includes mental health conditions and memory changes in its symptom list.
Fatigue deserves its own mention. The CDC calls it the most common symptom of lupus and notes that it affects physical and mental health and quality of life. Fatigue that heavy can look and feel like a thinking problem, which is one reason these symptoms are difficult to untangle without help.
Symptoms also move. The CDC describes flares, periods when symptoms increase, that come and go in waves and are sometimes years apart, along with periods of remission when symptoms temporarily recede. A quiet stretch does not mean the disease has resolved, and a bad stretch is not necessarily permanent.
- Headaches, dizziness, confusion, or seizures (NIAMS).
- Memory problems linked to changes in the brain and central nervous system (NIAMS).
- Mental health conditions and memory changes (CDC).
- Fatigue — the most commonly reported lupus symptom (CDC).
What is genuinely not known.
The CDC states plainly that the causes of lupus are not known, though they may be linked to a person's environment, family history, or hormonal factors. Most people with lupus do not have a relative with the disease.
Diagnosis is hard for a structural reason: lupus produces many symptoms that come and go and can mimic other disorders. NIAMS notes there is no single test that diagnoses lupus, and that a doctor may need to rule out other causes first. If your symptoms were dismissed or misread for a while before anyone said the word lupus, that path is common rather than unusual.
Be skeptical of anyone — including any website — who claims to know the cause of your lupus or offers a route around the uncertainty. The honest answer from the public health sources is that the cause is still open.
Lupus care belongs with a rheumatologist.
NIAMS states that most people will see a rheumatologist for their lupus treatment — a doctor who specializes in rheumatic diseases such as arthritis and other inflammatory or autoimmune disorders. Clinical immunologists may also treat people with lupus, and primary care providers are part of the picture.
The CDC describes lupus as having no cure while still being treatable, with the main treatment being medications that suppress the immune system, including hydroxychloroquine, corticosteroids such as prednisone, and biologics such as belimumab and rituximab. The CDC also describes a team approach, since lupus has many different symptoms and people with lupus may have other autoimmune conditions as well.
Read that as a boundary. Gates Brain Health is a functional neurology practice; Dr. Randall Gates, D.C., DACNB is a board-certified chiropractic neurologist, not a medical doctor and not a rheumatologist. This practice does not diagnose lupus, does not treat lupus, and is not a substitute for immunosuppressive therapy or for the specialist directing it. Decisions about lupus medications belong with the clinician who prescribes them. If you have lupus or suspect you do, a rheumatologist is who you need.
Some neurological changes should not wait.
Seizures and sudden confusion are among the central nervous system symptoms NIAMS associates with lupus, and they are not symptoms to sit on. A first-time seizure, a sudden change in alertness or thinking, or sudden weakness, numbness, speech trouble, or vision loss calls for emergency medical attention right away.
In those situations, phone 911 or get to an emergency department. Please do not wait on a return call from a routine office, and do not use this website to report anything urgent.
Questions worth asking when you call.
People with lupus sometimes call this office about cognitive or balance symptoms while their rheumatologist manages the disease itself. Whether that is a sensible fit is decided on a call and, if it goes further, an examination — not in advance and not by a web page.
The practice describes its role as complementary care worked out alongside your rheumatologist or primary care provider. So bring pointed questions, and expect direct answers about what is outside the scope here.
- Given that my rheumatologist manages my lupus, what would you actually be looking at?
- What would you not take on, and when would you tell me to go back to my specialist?
- How would you coordinate with the doctor prescribing my medications?
- What would you expect to learn from an examination, and what would it not tell us?