Purpose of Review

In recent years, the spectrum of neurological manifestations of antiphospholipid syndrome (APS) has been growing. We provide a critical review of the literature with special emphasis on presentation, proposed mechanisms of disease, and treatment of neurological involvement in APS.

Recent Findings

Although stroke is the most common cause of neurological manifestations in patients with APS, other neurological disorders have been increasingly associated with the disease, including cognitive dysfunction, headache, and epilepsy. Direct oral anticoagulants have failed to show non-inferiority compared to vitamin K antagonists for the prevention of major thrombotic events. Antiphospholipid antibodies are often found in patients with acute COVID-19 but clear evidence supporting an association between these antibodies and the risk of thrombotic events, including stroke and cerebral venous thrombosis, is still lacking.

Summary

APS patients may present with several distinct neurological manifestations. New criteria will facilitate the classification of patients presenting with increasingly recognized non-criteria neurological manifestations.

中文翻译：

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抗磷脂综合征的神经系统表现——最新进展

 审查目的

近年来，抗磷脂综合征（APS）的神经系统表现范围不断扩大。我们对文献进行了批判性回顾，特别强调 APS 的介绍、提出的疾病机制以及神经系统受累的治疗。

 最近的发现

尽管中风是 APS 患者神经系统表现的最常见原因，但其他神经系统疾病也越来越多地与该疾病相关，包括认知功能障碍、头痛和癫痫。与维生素 K 拮抗剂相比，直接口服抗凝剂在预防主要血栓事件方面未能显示出非劣效性。急性 COVID-19 患者中经常发现抗磷脂抗体，但仍缺乏支持这些抗体与血栓事件（包括中风和脑静脉血栓形成）风险之间存在关联的明确证据。

 概括

APS 患者可能会出现几种不同的神经系统表现。新标准将有助于对出现越来越多公认的非标准神经系统表现的患者进行分类。