scholarly journals Optic Nerve Atrophy in N-methyl-D-aspartate (NMDA) Encephalitis

2019 ◽  
Vol 47 (1) ◽  
pp. 139-141
Author(s):  
David C. Schulz ◽  
Sachin K. Pandey ◽  
Lulu L.C.D. Bursztyn
Keyword(s):  
Cerebrospinal Fluid ◽  
Optic Neuropathy ◽  
Psychiatric Symptoms ◽  
Upper Respiratory Tract ◽  
Optic Nerve Atrophy ◽  
Prodromal Symptoms ◽  
Nmda Receptor Encephalitis ◽  
Aspartate Receptor ◽  
Male Patients ◽  
Upper Respiratory

N-methyl-D-aspartate receptor (NMDA) encephalitis is a recently described autoimmune disease that typically presents with prodromal symptoms including upper respiratory tract infection, headache, fever, nausea, vomiting and diarrhea. Psychiatric symptoms follow within weeks, including anxiety, insomnia, mania, paranoia and grandiose delusions. The diagnosis is confirmed by the detection of NMDA antibodies in the serum or cerebrospinal fluid (CSF).1 Tumours, especially teratomas, are frequently associated with NMDA encephalitis; however, only 5% of male patients older than 18 years have been found to have an underlying tumour. Optic neuropathy associated with NMDA encephalitis is being increasingly recognised in the literature2–6 and was reviewed most recently by Mugavin et al.2 in 2017. In this report, we present a case of bilateral optic neuropathy in a young man diagnosed with NMDA receptor encephalitis.

Cerebrospinal fluid shunt infection due to Gemella haemolysans

2013 ◽  
Vol 11 (2) ◽  
pp. 205-209 ◽  
Author(s):  
William B. Lo ◽  
Mitul Patel ◽  
Guirish A. Solanki ◽  
Anthony Richard Walsh
Keyword(s):  
Cerebrospinal Fluid ◽  
Shunt Infection ◽  
Cns Infection ◽  
Upper Respiratory Tract ◽  
Cerebrospinal Fluid Shunt ◽  
Gram Staining ◽  
First Case ◽  
Full Neurological Recovery ◽  
Upper Respiratory ◽  
Ventriculoperitoneal Shunt Infection

Gemella haemolysans has long been considered a commensal in the human upper respiratory tract. Commensals are natural inhabitants on or within another organism, deriving benefit without harming or benefiting the host. Opportunistic infection of the CNS by the species is exceedingly rare. In the present case, a 16-year-old boy was admitted with a ventriculoperitoneal shunt infection, which was confirmed to be due to G. haemolysans. Following antibiotic treatment, removal of the old shunt, and delayed insertion of a new shunt, the patient made a full neurological recovery. To the authors' knowledge, this is the eighth case of CNS infection with G. haemolysans. Although prosthesis-related infections have been reported in other systems, this is the first case of CNS infection by the bacterium associated with an implant. Previous reported cases of CNS infection by G. haemolysans are reviewed. Due to the variable Gram staining property of the organism, the difficulty in diagnosing G. haemolysans infection is emphasized.

scholarly journals Psychiatric Symptoms in a Patient with NMDA Receptor Encephalitis

2020 ◽  
Vol 9 (1) ◽  
pp. 66-68
Author(s):  
L Paudel ◽  
S Samadarshi ◽  
S Limbu ◽  
R Sharma ◽  
P Chalise ◽  
...  
Keyword(s):  
Psychiatric Symptoms ◽  
Autoimmune Disorder ◽  
Behavioral Changes ◽  
Psychiatric Consultation ◽  
Course Of Illness ◽  
Nmda Receptor Encephalitis ◽  
Abnormal Movements ◽  
Aspartate Receptor ◽  
Autonomic Instability ◽  
Psychiatric Manifestations

Anti N methyl D aspartate receptor (NMDA-R) encephalitis is an autoimmune disorder that encompasses various psychiatric and neurological symptoms. Psychiatric manifestations are often the presentation of the disease that often delay or mislead the diagnosis. Complex psychiatric symptoms, seizures, autonomic instability, abnormal movements, behavioral changes and impaired cognitive functions are present during the course of illness. Prodromal psychiatric symptoms often confuse the physicians and even patient initially seeks psychiatric consultation. Here we present a case of 19 years female who presented with initial psychiatric symptoms that progressed to seizure, autonomic instability, abnormal movement and other encephalitic symptoms.

scholarly journals First Case Of SAR-Coronavirus-2 Sequencing In The Cerebrospinal Fluid Of A Patient With Suspected CNS Demyelinating Disease

2020 ◽  
Author(s):  
Renan Domingues ◽  
Maria Cássia Mendes-Correa ◽  
Fernando Brunale Vilela de Moura Leite ◽  
Ester Cerdeira Sabino ◽  
Ingra M Claro ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Viral Genome ◽  
Demyelinating Disease ◽  
Clinically Isolated Syndrome ◽  
The Novel ◽  
Upper Respiratory Tract ◽  
First Case ◽  
Demyelinating Lesions ◽  
Upper Respiratory ◽  
Novel Coronavirus

Abstract The association between coronaviruses and central nervous system (CNS) demyelinating lesions has been previously shown. However, no case has been described of an association between the novel coronavirus (SARS-COV-2) and CNS demyelinating disease so far. SARS-COV-2 was previously detected in cerebrospinal fluid (CSF) sample of a patient with encephalitis. However, the virus identity was not confirmed by deep sequencing of SARS-COV-2 detected in the CSF. Here, we report a case of a patient with mild respiratory symptoms and neurological manifestations compatible with Clinically Isolated Syndrome. The viral genome of SARS-COV-2 was detected and sequenced in CSF with 99.74 to 100% similarity between the patient virus and worldwide sequences. This report suggests a possible association of SARS COV-2 infection with neurological symptoms of demyelinating disease, even in the absence of relevant upper respiratory tract infection signs.

scholarly journals Guillain-Barré syndrome associated with COVID-19 disease

2020 ◽  
Vol 13 (9) ◽  
pp. e237215 ◽  
Author(s):  
Sindhuja Korem ◽  
Haresh Gandhi ◽  
Decerie Baculi Dayag
Keyword(s):  
Cerebrospinal Fluid ◽  
Clinical Course ◽  
Clinical Manifestations ◽  
Guillain Barre Syndrome ◽  
Upper Respiratory Tract ◽  
Cerebrospinal Fluid Analysis ◽  
Fluid Analysis ◽  
Guillain Barré Syndrome ◽  
Upper Respiratory ◽  
Guillain Barré

Clinical manifestations of COVID-19 are known to be variable with growing evidence of nervous system involvement. In this case report, we describe the symptoms of a patient infected with SARS-CoV-2 whose clinical course was complicated with Guillain-Barré syndrome (GBS). We present a case of a 58-year-old woman who was initially diagnosed with COVID-19 pneumonia due to symptoms of fever and cough. Two weeks later, after the resolution of upper respiratory tract symptoms, she developed symmetric ascending quadriparesis and paresthesias. The diagnosis of GBS was made through cerebrospinal fluid analysis and she was successfully treated with intravenous immunoglobulin administration.

scholarly journals Clinical Relevance of Cerebrospinal Fluid Antibody Titers in Anti-N-Methyl-d-Aspartate Receptor Encephalitis

2021 ◽  
Vol 12 (1) ◽  
pp. 4
Author(s):  
Meng-Ting Cai ◽  
Yang Zheng ◽  
Sa Wang ◽  
Qi-Lun Lai ◽  
Gao-Li Fang ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Psychiatric Symptoms ◽  
Autoimmune Encephalitis ◽  
Memory Deficits ◽  
Clinical Severity ◽  
Weak Correlation ◽  
Aspartate Receptor ◽  
Nmdar Encephalitis ◽  
Significant Difference ◽  
The Relationship

Anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis is the most common autoimmune encephalitis. To date, there has been no study on the relationship between antibody (Ab) titers and clinical phenotype. This study aims to clarify the relationship between cerebrospinal fluid Ab titers and clinical manifestations of anti-NMDAR encephalitis at onset. Seventy-six consecutive patients with a definite diagnosis were enrolled. The relationship between Ab titers and different onset symptoms including psychiatric symptoms, seizures, and memory deficits were analyzed. We further investigated the correlation between Ab titers and clinical severity as assessed by the modified Rankin scale (mRS) and the clinical assessment scale for autoimmune encephalitis (CASE), respectively. The Ab titers had a median value of 1:10 (range 1:1–1:100). There was no significant difference in titers among various clinical factors including gender and combination of tumor and other diseases (each p > 0.05). Patients presenting with psychiatric symptoms at onset had higher titers than those with seizures (p = 0.008) and memory deficits (p = 0.003). The mRS scores revealed a significant but weak correlation with Ab titers (r = 0.243, p = 0.034), while CASE scores did not correlate with the titers (p = 0.125). Our findings indicated that the Ab titers were associated with the type of onset symptoms, with a higher level of patients with psychiatric symptoms. Regarding the clinical severity, the titers showed a weak correlation with the mRS, but no correlation with the CASE.

scholarly journals The Relationship Between TLR 2 and 4 with Microbiota of Mouth and Nose in Hypersensitivity Type 1 Iraqi Patients

2019 ◽  
pp. 1452-1459
Author(s):  
Sulafa A. Aljubory ◽  
Mouruj A. Alaubydi
Keyword(s):  
Respiratory Tract ◽  
Age Groups ◽  
Upper Respiratory Tract ◽  
Normal Flora ◽  
Different Types ◽  
Male Patients ◽  
Upper Respiratory ◽  
Staphylococcus Spp ◽  
The Relationship

Hundreds of commensal bacteria are existed in the mouth and nose, and the interactions between these microbiotas and the Toll-like receptors (TLRs) in different parts of the upper respiratory tract, gastrointestinal tract, and immune cells maty assist to maintain the homeostasis of the immune system. Thus, it is importantto study the relationship between type one hypersensitivity and normal flora in the mouth and nose. Blood and saliva or sputum samples of seventy-one allergic patients were collected randomly in Baghdad/ Al- Zahraa center for asthma and allergies. Those patients were suffering from different types of hypersensitivity type1 such as skin and respiratory tract allergy (e.g, asthma and Rhinitis). The results revealed that the allergic females percentage were more than males. Staphylococcus spp., Lactobacillus and Fungi spp. isolated from the mouth and nose were more prevalent than other microorganisms among different age groups. In addition, most age groups were given significant variation in TLR2 level, while TLR4 recorded variation in female more than male patients. 

scholarly journals Anti-N-Methyl-D-Aspartate Receptor Encephalitis with Ovarian Teratoma Improved by Prompt Surgery

2021 ◽  
Vol 39 (4) ◽  
pp. 340-342
Author(s):  
Seok-Yeol Yang ◽  
Wooryang Byun ◽  
Sung-Pa Park ◽  
Jong-Geun Seo
Keyword(s):  
Cerebrospinal Fluid ◽  
Clinical Outcome ◽  
Clinical Symptoms ◽  
Psychiatric Symptoms ◽  
Clinical Manifestations ◽  
Early Surgery ◽  
Ovarian Teratoma ◽  
Aspartate Receptor ◽  
Early Removal ◽  
Nmdar Encephalitis

Anti-N-methyl-D aspartate receptor (NMDAR) encephalitis is often accompanied with ovarian teratomas. It has a variety of clinical manifestations including psychiatric symptoms, seizure, and motor dysfunctions. The diagnosis can be definite when clinical symptoms are present and anti-NMDAR antibodies in cerebrospinal fluid are detected. However, in patients with suspected anti-NMDAR encephalitis with teratomas, early surgery may help the clinical outcome even if the antibodies are initially negative. The authors report a patient whose clinical symptoms improved significantly after early removal of teratoma.

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