Primary antiphospholipid antibody syndrome presenting with encephalopathy, psychosis and seizures

Antiphospholipid syndrome (APS) is an autoimmune disease characterized by recurrent thrombotic events, miscarriages and thrombocytopenia with persistently positive antiphospholipid antibodies. ^1,2 APS may be isolated (primary APS) or associated to a connective tissue disease, most often systemic lupus erythematosus (SLE). ^1,2 APS usually affects young patients before the fifth decade ³ with stroke being the commonest neurological manifestation. ⁴ Various other neurological manifestations are being recognized in patients with APS including migraine, epilepsy, multi-infarct dementia and chorea. ² The pathological process underlying the neurological manifestations remains obscure. ^1,2 Herein we report a case of primary APSpresenting with a group of unusual neurological manifestations in a 68-year-old woman.