cognitive dysfunction with and without lupus cerebritis

  : : I am currently home on disability for a lupus flare.  I am usually ANA negative, and the SED rate is sometimes but not always normal.  I take NSAIDS and 8 mg. prednisone (current dose) along with synthroid, estrogen patch, and medicine for allergies and asthma.  My question has to do with a sharp decline in my cognitive abilities over the past few months. As the flare worsened, I began having severe difficulties with short-term memory and concentration, and my speech changed. When I talk, I frequently must allow a long pause between words because I cannot "pull up" the next thing I'm going to say.  I know that the content is sometimes repetitive and somewhat labile as well.  I am a school psychologist, and unless or until this gets cleared up, I can't return to work.  (Thinking and speaking being a prerequisite for the job!)  :-)  I have had a neurological consult, and he has referred me for an MRI and and EEG, and says if those are negative, he'll assume it's not the lupus and send me to a neuropsychologist to look at affective issues instead.  My question is, what are the appropriate tests for CNS lupus?  Does it always show up in an MRI or EEG?  And if it's more subtle and requires a neuropsych exam, does that really mean it isn't the lupus? Will it likely improve? This has ramifications for my disability claim, obviously, and I need to know whether this doctor is doing enough and doing the right thing.  Thanks for your help.
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[CCF Neuro[P] MD RPS]

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