%0 Journal Article
%T Jaw Dystonia and Reversible Basal Ganglia Changes as an Initial Presentation of Systemic Lupus Erythematosus
%A Meghan Romba
%A Sandeep Khot
%A Shu-Ching Hu
%A Yujie Wang
%J Archive of "The Neurohospitalist".
%D 2018
%R 10.1177/1941874417698323
%X Dystonia as a manifestation of neuropsychiatric lupus erythematosus (NPSLE) is uncommon. We report a 25-year-old woman who experienced progressive confusion, reduced speech, and difficulty opening her mouth approximately 2 weeks after development of a facial rash. Brain imaging showed bilateral, symmetric signal abnormalities within the basal ganglia and subcortical white matter. Despite treatment with high-dose steroids, she continued to have difficulty speaking with evidence of jaw dystonia on examination. Jaw dystonia rapidly improved with the initiation of levodopa. Repeat evaluation 3 months later exhibited the absence of jaw dystonia and near resolution of the imaging abnormalities. Our patient demonstrated a unique presentation with jaw dystonia refractory to traditional treatment for NPSLE. Such a presentation likely represents a severe variant of NPSLE requiring both immunosuppressive and symptomatic therapies
%K movement disorders
%K clinical specialty
%K neuroimmunology
%K dystonic disorders
%K parkinsonian disorders
%K imaging techniques
%U https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5734500/