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Neuropsychiatric symptoms correlated with autoimmune diseases of the nervous system

Przemysław Robert Dalski-Szeląg1, Roksana Grzeszczak1, Milena Zaremba2, Magdalena Grabińska3, Wojciech Mikołaj Szkudlarek4, Maksym K. Gmur1

Affiliation and address for correspondence
Aktualn Neurol 2025; 25 (2)
10.15557/AN.2025.0014
Abstract

Autoimmune diseases of the nervous system often cause neuropsychiatric symptoms, which can both herald the disease and indicate its exacerbation. This paper discusses autoimmune diseases of the nervous system in which neuropsychiatric symptoms occur particularly frequently or are especially severe, such as systemic lupus erythematosus, chronic inflammatory demyelinating polyneuropathy, multiple sclerosis, Hashimoto’s encephalopathy, Guillain–Barré syndrome, paediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS), and myasthenia gravis, with particular emphasis on their neuropsychiatric symptoms. In systemic lupus erythematosus, neuropsychiatric symptoms affect 30–40% of patients and may include cognitive impairments, psychosis, headaches, mood disorders, and others. Hashimoto's encephalopathy is a rare but serious disease requiring rapid immunosuppressive intervention, manifesting with cognitive dysfunction, seizures, productive symptoms, mood changes, and more. Multiple sclerosis, in addition to the neurological symptoms typical for disease relapses, also causes symptoms such as fatigue affecting about 80% of patients, depression, anxiety, and cognitive dysfunctions. Myasthenia gravis, besides its typical symptoms, often also features neuropsychiatric symptoms such as chronic fatigue, anxiety, and sleep disorders. Neuropsychiatric symptoms of autoimmune diseases of the nervous system, particularly depression, cognitive impairments, anxiety, psychosis, but also others, significantly reduce patients quality of life, and early identification of these symptoms is crucial not only for improving quality of life but also often for enhancing patient prognosis and reducing neurological complications.

Keywords
multiple sclerosis, lupus erythematosus, autoimmune diseases, neuropsychiatric symptoms, Hashimoto’s encephalopathy

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