['Systemic lupus erythematosus may present with a wide variety of neurological manifestations, which could be related to the presence of vasculopathy and microembolic signals (MES).', 'We aimed to determine the prevalence of MES and altered blood flow velocities (BFVs) by transcranial Doppler (TCD) in patients with acute neuropsychiatric lupus erythematosus (NPLE).', 'Fifteen consecutive patients with acute NPLE (cases) and 30 patients with systemic lupus erythematosus but without acute NPLE (controls) underwent TCD testing for comparison purposes.', 'We found higher mean BFVs in cases compared with controls in the left (100 vs. 73.5 cm/s, p = 0.018) and in the right (96 vs. 70 cm/s, p = 0.013) middle cerebral arteries. The proportion of MES in both groups was the same (13%). Abnormal TCDs were more frequent in patients with acute NPLE, 67 versus 17% (p = 0.001), and occurred more often in patients who presented seizures.'] Is acute neurolupus manifested by seizures associated with high frequency of abnormal cerebral blood flow velocities?