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Arthritis and Rheumatism

Swelling on the Brain and RA

07/19/2007

Question:

A friend of mine went to the ER due to having problems with headache and can`t concentrate. The doctor told her that she has swelling on her brain and it was caused by her RA, Lupus, or the medications to treat them. I also have RA. Have you ever herd of this before and how often does it occur? Which one is most likely to have caused this to happen?

Answer:

Between the diseases of Rheumatoid Arthritis (RA) and Systemic Lupus Erythematosus (SLE), SLE would be more likely to cause central nervous system (CNS) dysfunction. It is difficult to know what exactly the Emergency Department physician meant by "brain swelling." However, true cerebral inflammation or cerebral blood vessel inflammation due to SLE can be difficult to diagnosis. Furthermore, the diagnosis should be made cautiously due to multiple other potential causes of abnormal images on CT or MRI scans. It would be advisable for your friend to seek further consultation regarding the findings in the Emergency Department.

RA is more likely to have peripheral neurologic manifestations, such as effects on peripheral nerves. In severe RA that has caused instability the spine in the neck region, the unstable vertebrae can compress the spinal cord or nerve roots. This would not give the appearance of "brain inflammation."

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Response by:

Raymond  Hong, MD, MBA, FACR Raymond Hong, MD, MBA, FACR
Formerly, Assistant Professor of Medicine
School of Medicine
Case Western Reserve University