The Neurological Manifestations as an Onset Symptom of Antiphospholipid Syndrome: Report of Two Cases

The Antiphospholipid Syndrome (APS) is defined by the occurrence of multiple venous and arterial thrombosis. In this condition, the presence of anti-phospholipid antibodies (aPL), namely lupus anticoagulant (LA), anti-Cardiolipin antibodies (acl) or anti-beta 2 glycoprotein 1 antibodies is necessary for diagnosis[1,2]. The prevalence of aPL seropositive ranges between 1-5% in the general population, but only a minority of these individuals develop the APS[1]. For the definite diagnosis of APS at least one clinical feature such as vascular thrombosis or pregnancy morbidity and one laboratory abnormality must be observed. The laboratory abnormalities must be present on two or more occasions at least 12 weeks apart[3]. The cerebral involvement in APS is common and characterized by different clinical manifestations; they could be the first presenting feature or appear in the course of the disease. The reported manifestations of the cerebral involvement are: cerebral ischemic events such as CVA and TIA, epilepsy, dementia, cognitive deficit, headache, psychiatric disorders, chorea, MSlike syndrome, transverse myelitis and ocular symptoms. It is notable to mention that the presence of aPL in patients without criteria for APS may also be associated with neuropsychiatric and cognitive disturbances.