Severe acute disseminated encephalomyelitis complicating measles infection

2020 ◽  
Vol 13 (11) ◽  
pp. e237346
Author(s):  
Hamish Duncan Morrison ◽  
Clemency Clarke ◽  
Richard James ◽  
Nicola Giffin
Keyword(s):  
Measles Virus ◽  
Herd Immunity ◽  
Active Role ◽  
Acute Disseminated Encephalomyelitis ◽  
Neurological Complications ◽  
The Public ◽  
Fluid Analysis ◽  
Progressive Encephalopathy ◽  
Brain And Spinal Cord ◽  
The Brain

A 36-year-old man presented with an acute progressive encephalopathy, followed by tetraparesis and was diagnosed with acute disseminated encephalomyelitis (ADEM) complicating infection with measles virus. Despite demonstrating a typical rash and other early symptoms of measles infection, there was uncertainty around the initial diagnosis. Cerebrospinal fluid analysis and MRI of the brain and spinal cord were consistent with severe ADEM. He required treatment on intensive care but responded favourably to immunosuppressive therapy.This case highlights the importance of recognising acute measles infection, familiarity with the neurological complications and the potential for good outcome. Healthcare professionals must continue to play an active role in educating the public on the importance of maintaining herd immunity through universal immunisation.

scholarly journals A Case of Acute Encephalopathy Due to Autoimmune Overload

2020 ◽  
Vol 5 (6) ◽  
Keyword(s):  
Multiple Sclerosis ◽  
Spinal Cord ◽  
Pediatric Population ◽  
Autoimmune Disorder ◽  
Acute Disseminated Encephalomyelitis ◽  
Acute Encephalopathy ◽  
Demyelinating Disorder ◽  
Demyelinating Disorders ◽  
Brain And Spinal Cord ◽  
The Brain

Acute disseminated encephalomyelitis, also known as postinfectious encephalomyelitis, is considered an autoimmune disorder that causes inflammation of the brain and spinal cord. It was seen mainly in pediatric population possibly due to vaccination but there have been cases identified in adult [1-9]. Acute disseminated encephalomyelitis can be challenging to diagnose owing to fact that there have been many overlapping symptoms among other demyelinating disorder such multiple sclerosis and Neuromyelitis Optica. In this case report, we will discuss a case about a patient that presented due to acute encephalopathy and was noted to have an atypical MRI of the brain that was not consistent with results of the lumbar puncture [10-12]. Knowledge gained from this case will help bring awareness to the diagnose of acute disseminated encephalomyelitis and how imaging in context with the clinical picture can help us differentiate between the various demyelinating disorders; thereby, giving a better understanding of managing these patients as management can affect prognosis and outcomes.

Acute Disseminated Encephalomyelitis in a 2-Year-Old Patient Following COVID-19

2021 ◽  
Author(s):  
Amy Robinson ◽  
Louise Chapman ◽  
Wendy Watts
Keyword(s):  
Oral Prednisolone ◽  
Acute Disseminated Encephalomyelitis ◽  
Neurological Complications ◽  
High Signal ◽  
Resonance Imaging ◽  
Intermittent Fever ◽  
Intravenous Methylprednisolone ◽  
Ataxic Gait ◽  
Truncal Ataxia ◽  
The Brain

AbstractThis report presents the case of acute disseminated encephalomyelitis in a 2-year-old patient following a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test. She presented with ataxic gait, truncal ataxia, and reduced coordination following 10 days of intermittent fever and lethargy. She did not have any respiratory symptoms. Magnetic resonance imaging of the brain and spine showed widespread T2 high signal within the gray and white matters and within the spinal cord. She was treated with intravenous methylprednisolone followed by tapering oral prednisolone; this led to resolution of her neurological symptoms. This case highlights that neurological complications can occur secondary to SARS-CoV-2 infection.

scholarly journals Analysis of a Subacute Sclerosing Panencephalitis Genotype B3 Virus from the 2009-2010 South African Measles Epidemic Shows That Hyperfusogenic F Proteins Contribute to Measles Virus Infection in the Brain

2018 ◽  
Vol 93 (4) ◽  
Author(s):  
Fabrizio Angius ◽  
Heidi Smuts ◽  
Ksenia Rybkina ◽  
Debora Stelitano ◽  
Brian Eley ◽  
...  
Keyword(s):  
Brain Tissue ◽  
Measles Virus ◽  
Subacute Sclerosing Panencephalitis ◽  
Neurological Complications ◽  
Neural Cells ◽  
Viral Receptor ◽  
Tissue Samples ◽  
F Protein ◽  
Recombinant Viruses ◽  
The Brain

ABSTRACTDuring a measles virus (MeV) epidemic in 2009 in South Africa, measles inclusion body encephalitis (MIBE) was identified in several HIV-infected patients. Years later, children are presenting with subacute sclerosing panencephalitis (SSPE). To investigate the features of established MeV neuronal infections, viral sequences were analyzed from brain tissue samples of a single SSPE case and compared with MIBE sequences previously obtained from patients infected during the same epidemic. Both the SSPE and the MIBE viruses had amino acid substitutions in the ectodomain of the F protein that confer enhanced fusion properties. Functional analysis of the fusion complexes confirmed that both MIBE and SSPE F protein mutations promoted fusion with less dependence on interaction by the viral receptor-binding protein with known MeV receptors. While the SSPE F required the presence of a homotypic attachment protein, MeV H, in order to fuse, MIBE F did not. Both F proteins had decreased thermal stability compared to that of the corresponding wild-type F protein. Finally, recombinant viruses expressing MIBE or SSPE fusion complexes spread in the absence of known MeV receptors, with MIBE F-bearing viruses causing large syncytia in these cells. Our results suggest that alterations to the MeV fusion complex that promote fusion and cell-to-cell spread in the absence of known MeV receptors is a key property for infection of the brain.IMPORTANCEMeasles virus can invade the central nervous system (CNS) and cause severe neurological complications, such as MIBE and SSPE. However, mechanisms by which MeV enters the CNS and triggers the disease remain unclear. We analyzed viruses from brain tissue of individuals with MIBE or SSPE, infected during the same epidemic, after the onset of neurological disease. Our findings indicate that the emergence of hyperfusogenic MeV F proteins is associated with infection of the brain. We also demonstrate that hyperfusogenic F proteins permit MeV to enter cells and spread without the need to engage nectin-4 or CD150, known receptors for MeV that are not present on neural cells.

scholarly journals Spontaneous Subarachnoid Haemorrhage in a Case with Covid-19 Infection - Effect or Association? A Case Report

2021 ◽  
Vol 10 (41) ◽  
pp. 3607-3609
Author(s):  
Sourya Acharya ◽  
Samarth Shukla ◽  
Pankaj Banode ◽  
Shefali Sharma ◽  
Abhijeet Wadekar
Keyword(s):  
Subarachnoid Haemorrhage ◽  
Severe Pneumonia ◽  
Haemorrhagic Stroke ◽  
Airway Disease ◽  
Acute Disseminated Encephalomyelitis ◽  
Neurological Complications ◽  
Multiple Organ ◽  
Chronic Obstructive ◽  
Acute Necrotizing Encephalopathy ◽  
The Brain

Covid-19 is a disease caused by the SARS-CoV-2 virus that usually causes mild flu-like illness in majority of the cases, but it can cause severe pneumonia and multiple organ dysfunction even death especially in elderly patients who also have comorbidities like hypertension, diabetes, chronic obstructive airway disease (COAD), asthma, and cardiac disease. The central and peripheral nervous systems are not spared, and neurological complications are frequently reported in severely ill patients who have comorbidities. The SARS-CoV-2 virus has the potential to invade the brain and it enters the brain via a haematogenous route or olfactory system through angiotensinconverting enzyme -2 receptors, present on endothelial cells of cerebral vessels. The most neurological manifestations, seen in Covid-19 infection are altered sensorium (agitation, delirium, and coma), ischemic or haemorrhagic stroke, acute disseminated encephalomyelitis or acute necrotizing encephalopathy, headaches, Guillain-Barré syndrome. Here is a case of a 70-year-old hypertensive female who presented to us with complaints of fever, headache and vomiting of 3 days duration and after investigations, a diagnosis of Covid -19 with hypertension and subarachnoid haemorrhage was made.

scholarly journals Rituximab Treatment in Acute Disseminated Encephalomyelitis Associated with Salmonella Infection

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Ebru Kacmaz ◽  
Gurkan Bozan ◽  
Kursat Bora Carman ◽  
Omer Kilic ◽  
Mehmet Ozgur Arslanoglu ◽  
...  
Keyword(s):  
Case Reports ◽  
Acute Disseminated Encephalomyelitis ◽  
Salmonella Infection ◽  
Pediatric Case ◽  
First Line Therapy ◽  
The Central Nervous System ◽  
High Doses ◽  
Progressive Disorder ◽  
Brain And Spinal Cord ◽  
The Brain

Acute disseminated encephalomyelitis (ADEM) is an inflammatory, demyelinating, and rapidly progressive disorder of the central nervous system. This condition is also known as postinfectious encephalomyelitis, and it is characterized by multifocal lesions in the brain and spinal cord with widespread neurological findings. High doses of intravenous (IV) methylprednisolone, intravenous immunoglobulin (IVIG), and plasma exchange (PLEX) treatments comprise the first-line therapy. There are limited pediatric case reports refractory to standard treatment. Here, we present the case of a 17-year-old girl diagnosed with ADEM associated with Salmonella infection, which was treated with rituximab.

scholarly journals Cerebrospinal fluid confirmed COVID-19-associated encephalitis treated successfully

2020 ◽  
Vol 13 (9) ◽  
pp. e237378 ◽  
Author(s):  
Yasmine Mohamed Kamal ◽  
Yasmin Abdelmajid ◽  
Abubaker Abdul Rahman Al Madani
Keyword(s):  
Cerebrospinal Fluid ◽  
Respiratory Symptoms ◽  
Medical Literature ◽  
Clinical Presentation ◽  
Early Recognition ◽  
Neurological Complications ◽  
Red Flags ◽  
Cerebrospinal Fluid Analysis ◽  
Fluid Analysis ◽  
The Brain

The COVID-19 pandemic that attracted global attention in December 2019 is well known for its clinical picture that is consistent with respiratory symptoms. Currently, the available medical literature describing the neurological complications of COVID-19 is gradually emerging. We hereby describe a case of a 31-year-old COVID-19-positive patient who was admitted on emergency basis. His clinical presentation was primarily neurological, rather than the COVID-19’s classical respiratory manifestations. He presented with acute behavioural changes, severe confusion and drowsiness. The cerebrospinal fluid analysis was consistent with COVID-19 encephalitis, as well as the brain imaging. This experience confirms that neurological manifestations might be expected in COVID-19 infections, despite the absence of significant respiratory symptoms. Whenever certain red flags are raised, physicians who are involved in the management of COVID-19 should promptly consider the possibility of encephalitis. Early recognition of COVID-19 encephalitis and timely management may lead to a better outcome.

Use of Protein a Conjugated to Peroxidase to Localize Immunoglobulin G in SSPE Ferret Brain

1982 ◽  
Vol 40 ◽  
pp. 350-351
Author(s):  
Hannah R. Brown ◽  
Anthony F. Nostro ◽  
Halldor Thormar
Keyword(s):  
Immunoglobulin G ◽  
Human Disease ◽  
Measles Virus ◽  
Subacute Sclerosing Panencephalitis ◽  
Protein A ◽  
Inflammatory Lesions ◽  
Sspe Virus ◽  
Specific Immunoglobulin ◽  
Antibody Titers ◽  
The Brain

Subacute sclerosing panencephalitis (SSPE) is a slowly progressing disease of the CNS in children which is caused by measles virus. Ferrets immunized with measles virus prior to inoculation with the cell associated, syncytiogenic D.R. strain of SSPE virus exhibit characteristics very similar to the human disease. Measles virus nucleocapsids are present, high measles antibody titers are found in the sera and inflammatory lesions are prominent in the brains. Measles virus specific immunoglobulin G (IgG) is present in the brain,and IgG/ albumin ratios indicate that the antibodies are synthesized within the CNS.

Presence of antibody in virus-infected brain cells of SSPE ferrets

1983 ◽  
Vol 41 ◽  
pp. 804-805
Author(s):  
Hannah R. Brown ◽  
Tammy L. Donato ◽  
Halldor Thormar
Keyword(s):  
Measles Virus ◽  
Plasma Cells ◽  
Subacute Sclerosing Panencephalitis ◽  
Protein A ◽  
Neutralizing Antibody ◽  
Brain Cells ◽  
Antibody Titers ◽  
A Cell ◽  
The Central Nervous System ◽  
The Brain

Measles virus specific immunoglobulin G (IgG) has been found in the brains of patients with subacute sclerosing panencephalitis (SSPE), a slowly progressing disease of the central nervous system (CNS) in children. IgG/albumin ratios indicate that the antibodies are synthesized within the CNS. Using the ferret as an animal model to study the disease, we have been attempting to localize the Ig's in the brains of animals inoculated with a cell associated strain of SSPE. In an earlier report, preliminary results using Protein A conjugated to horseradish peroxidase (PrAPx) (Dynatech Diagnostics Inc., South Windham, ME.) to detect antibodies revealed the presence of immunoglobulin mainly in antibody-producing plasma cells in inflammatory lesions and not in infected brain cells.In the present experiment we studied the brain of an SSPE ferret with neutralizing antibody titers of 1:1024 in serum and 1:512 in CSF at time of sacrifice 7 months after i.c. inoculation with SSPE measles virus-infected cells. The animal was perfused with saline and portions of the brain and spinal cord were immersed in periodate-lysine-paraformaldehyde (P-L-P) fixative. The ferret was not perfused with fixative because parts of the brain were used for virus isolation.

Pelvic schwannoma

GYNECOLOGY ◽  
2020 ◽  
Vol 22 (5) ◽  
pp. 84-86
Author(s):  
Sergei P. Sinchikhin ◽  
Sarkis G. Magakyan ◽  
Oganes G. Magakyan
Keyword(s):  
Auditory Nerve ◽  
World Literature ◽  
Morphological Study ◽  
Clinical Observation ◽  
Nerve Trunk ◽  
Practical Case ◽  
Surgical Volume ◽  
The World ◽  
Brain And Spinal Cord ◽  
The Brain

Relevance.A neoplasm originated from the myelonic sheath of the nerve trunk is called neurinoma or neurilemmoma, neurinoma, schwannoglioma, schwannoma. This tumor can cause compression and dysfunction of adjacent tissues and organs. The most common are the auditory nerve neurinomas (1 case per 100 000 population per year), the brain and spinal cord neurinomas are rare. In the world literature, there is no information on the occurrences of this tumor in the pelvic region. Description.Presented below is a clinical observation of a 30-year-old patient who was scheduled for myomectomy. During laparoscopy, an unusual tumor of the small pelvis was found and radically removed. A morphological study allowed to identify the remote neoplasm as a neuroma. Conclusion.The presented practical case shows that any tumor can hide under a clinical mask of another disease. The qualification of the doctor performing laparoscopic myomectomy should be sufficient to carry out, if necessary, another surgical volume.

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