TIZIMLI QIZIL YUGURIK (SLE) NING OG‘IR NEVROLOGIK ASORATI SIFATIDA RIVOJLANGAN LUPUS-ENSEFALOPATIYA: PATOGENEZ, DIAGNOSTIKA VA DAVOLASH YONDASHUVLARI

Abstract

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that may affect multiple organs, including the central nervous system. Neuropsychiatric SLE (NPSLE) comprises a heterogeneous spectrum of neurological and psychiatric manifestations, ranging from cognitive dysfunction and mood disturbances to seizures, acute confusional states, psychosis, and cerebrovascular events. Lupus encephalopathy is a clinically important presentation in which altered mental status and neurological dysfunction may occur in association with SLE, although the term is not uniformly defined and alternative causes must be carefully excluded. This narrative review summarizes current understanding of proposed inflammatory and ischemic mechanisms, clinical presentation, diagnostic assessment, differential diagnosis, and treatment principles of severe central nervous system involvement in SLE. No single laboratory test or neuroimaging finding can reliably confirm NPSLE. Diagnosis therefore relies on clinical assessment, evaluation of SLE activity, brain magnetic resonance imaging, cerebrospinal fluid analysis when indicated, electroencephalography, and systematic exclusion of infection, metabolic disturbances, medication-related effects, and thrombotic disease. Treatment is individualized according to the presumed mechanism and severity. Inflammatory manifestations may require glucocorticoids and immunosuppressive therapy, whereas antiphospholipid antibody-associated thrombotic events may require antiplatelet or anticoagulant treatment. Early recognition and multidisciplinary management are essential, while further studies are needed to improve biomarkers and evidence-based therapeutic strategies.