Patient selection: systemic lupus erythematosus (SLE)
Risk factors for a seizure after the diagnosis of SLE:
(1) history low serum C3 or C4 concentration
(2) psychosis, organic brain syndrome, aseptic meningitis, cerebrovascular disease, cognitive impairment or abnormal brain CT
(3) cranial and/or peripheral neuropathy
(4) presence of anti-Smith antibody
(5) renal involvement with proteinuria (3+ or greater)
(6) current corticosteroid dose
The longer that the person had the SLE the lower the risk, with the highest risk for a first seizure in the first 3 years after diagnosis (Table 2).
Daily Dose of Prednisone
|
Adjusted Relative Risk
|
1 to 9 mg/day
|
1.8
|
10 to 19 mg/day
|
4.0
|
>= 20 mg/day
|
11.8
|