Central Nervous System Manifestations of Antiphospholipid Syndrome

Neurologic manifestations are common in patients with antiphospholipid antibodies and include stroke, seizures, dementia, cognitive dysfunction, chorea, migraine, psychosis, and demyelinating disease. Many of these disorders mimic their idiopathic counterparts, but treatment of antiphospholipid antibody-associated disease can be different from the treatment of central nervous system disease not associated with these antibodies. For patients with antiphospholipid antibody-associated neurologic disease, anticoagulation or immunosuppressive therapy or both may significantly improve their symptoms. Thus, clinicians should have a high index of suspicion for antiphospholipid syndrome in the appropriate clinical context.