|
| Neurological manifestations associated with antiphospholipid syndrome | Features |
|
| Thrombotic manifestations | |
| Spinal cord stroke | Uncommon feature; less frequent than transverse myelitis |
| Acute ischemic encephalopathy | Uncommon feature in APS secondary to SLE; presents with tetraparesis, confusion, and hyperreflexia |
Ischemic stroke
Transient ischemic attack (TIA) | The most common manifestations of APS; important cause of juvenile stroke; any brain region can be interested |
| Cerebral venous thrombosis | Uncommon vascular manifestation |
|
| Nonthrombotic manifestations | |
| Headache | Frequent and often untreatable; no definite association between aPL positivity and type of headache [34] |
| Multiple sclerosis | APS can mimic multiple sclerosis; no definite tests to differentiate these entities are available |
| Transverse myelitis | Rare acute inflammatory manifestation; more common in APS secondary to SLE |
| Sensorineural hearing loss | Acute onset in the presence of aPL may be a manifestation of APS [37] |
| Guillain-Barrè syndrome | Antiphospholipid antibodies probably produced as a result of myelin damage |
| Peripheral neuropathy | Mononeuritis multiplex due to vasculitis is most commonly found in SLE; axonal neuropathy can be asymptomatic in PAPS |
| Cognitive dysfunction and dementia | Caused by multiple brain strokes; Alzheimer's disease-like dementia in 6% of cases |
| Idiopathic intracranial hypertension | Can be the presenting feature of APS |
| Epilepsy | In 10% of patients; primary or secondary to stroke |
| Chorea and other movement disorders | Rarely due to stroke in the basal ganglia; frequent in patients with APS secondary to SLE |
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