Recurrent stroke andmulti-infarct dementia in systemic lupuserythematosus: association with antiphospholipid antibodies

SUMMARY Fourpatients withrecurrent stroke andmulti-infarct dementia arepresented in whomthedementia was progressive andsevere.Threeofthepatients developed thedementia during thecourseofanillness which was punctuated byrepeated episodes ofcerebral infarction demonstrated bycomputed tomographic (CT)scans.Thefourth patient presented with anillness dominated byprogressive anddeteriorating higher mental functions, whichculminated ina majorstroke 18monthslater. Threepatients fulfilled theAmerican Rheumatism Association (ARA)criteria fortheclassification ofsystemic lupus erythematosus, thefourth hada 'lupuslike' disease. Allhadlivedo reticularis, severemigraines, andalsodemonstrated antibodies to phospholipids. Allfourpatients suffered deepveinthromboses.