Neuropsychiatric Manifestations of Antiphospholipid Syndrome

Abstract

Neurologic manifestations are challenging in the antiphospholipid syndrome (APS) due to their partially understood etiopathogenesis and potential severity. Stroke, cognitive dysfunction, migraine, seizure, chorea, myelitis, and multiple sclerosis-like disease are reported in antiphospholipid antibody (aPL)-positive patients; however a strong association has only been reported between aPL and cerebral ischemia/infarction. Clinical studies are mostly underpowered. Small sample size and/or retrospective design limits the ability to conclude on the potential associations between nonischemic neurological manifestations and aPL. Although some evidence of a direct immune effect of aPL on the brain is supported by animal studies and human research, further clinical studies of patients enrolled based on internationally accepted APS/aPL definitions, and neuroimaging studies are needed to better evaluate the impact of these manifestations in APS.