scholarly journals Mature ovarian teratoma-associated encephalitis

2022 ◽  
pp. 4-4
Author(s):  
Anita Krsman ◽  
Branislava Baturan ◽  
Dmitar Vlahovic ◽  
Zorica Grujic ◽  
Djordje Petrovic ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Mature Teratoma ◽  
Autoimmune Encephalitis ◽  
Complete Recovery ◽  
Neurological Status ◽  
Sudden Onset ◽  
Cranial Computed Tomography ◽  
Ovarian Teratoma ◽  
Unusual Behavior ◽  
Clinical Conditions

Introduction. Autoimmune encephalitis associated with ovarian teratoma is a serious and potentially fatal pathology. While this clinical entity is known to neurologists, the available literature rarely mentions the role of a gynecologist in diagnostic imagining and treatment. Although several months have passed from the appearance of the symptoms to surgical treatment, this case shows that even then a complete recovery is possible. Case presentation. The patient was a 28-year-old female, brought to the hospital because a sudden onset of unusual behavior - an acute psychosis with suicidal thoughts and auditory hallucinations. Soon after the admission she became delirious, uncooperative and agitated. Blood check, neurological assessment and cranial computed tomography yielded normal results. Therefore, a psychiatric disorder was suspected. Electroencephalogram revealed a diffuse encephalitic insufficiency. As cerebrospinal fluid was negative for infections, the autoimmune etiology of the disease was suspected. Abdominal computer tomography showed a complex right ovarian mass measuring 50 x 40 x 30 mm, confirmed by vaginal ultrasound. Laparoscopy with right adnexectomy was performed. The pathohistological finding showed a mature teratoma. In the meantime, the result of the cerebrospinal fluid test came positive for anti NMDAR antibodies. Six months after surgery, the patient was in a good mental and neurological status without symptoms. Conclusion. Gynecologists should be aware of the presence of ovarian tumors in encephalitis cases. A timely diagnosis of the underlying gynecological cause of a neurological condition, allows for prompt treatment and can remarkably improve clinical conditions and, thus, be lifesaving.

scholarly journals Autoimmune Encephalitis and CSF Anti-GluR3 Antibodies in an MS Patient after Alemtuzumab Treatment

2019 ◽  
Vol 9 (11) ◽  
pp. 299 ◽  
Author(s):  
Maria Chiara Buscarinu ◽  
Arianna Fornasiero ◽  
Giulia Pellicciari ◽  
Roberta Reniè ◽  
Anna Chiara Landi ◽  
...  
Keyword(s):  
Cognitive Deficits ◽  
Focal Epilepsy ◽  
Brain Magnetic Resonance Imaging ◽  
Autoimmune Encephalitis ◽  
Complete Recovery ◽  
Neurological Status ◽  
Relapsing Remitting ◽  
The Central Nervous System ◽  
Relapsing Remitting Multiple Sclerosis ◽  
Serial Brain

A 45-year-old Italian woman, affected by relapsing–remitting multiple sclerosis (RR-MS) starting from 2011, started treatment with alemtuzumab in July 2016. Nine months after the second infusion, she had an immune thrombocytopenic purpura (ITP) with complete recovery after steroid treatment. Three months after the ITP, the patient presented with transient aphasia, cognitive deficits, and focal epilepsy. Serial brain magnetic resonance imaging showed a pattern compatible with encephalitis. Autoantibodies to glutamate receptor 3 peptide A and B were detected in cerebrospinal fluid and serum, in the absence of any other diagnostic cues. After three courses of intravenous immunoglobulin (0.4 mg/kg/day for 5 days, 1 month apart), followed by boosters (0.4 mg/kg/day) every 4–6 weeks, her neurological status improved and is currently comparable with that preceding the encephalitis. Autoimmune complications of the central nervous system during alemtuzumab therapy are relatively rare: only one previous case of autoimmune encephalitis following alemtuzumab treatment has been reported to date.

Rapidly Progressive Memory Loss, Mood Change, Mutism, and Abnormal Movements

2021 ◽  
pp. 83-85
Author(s):  
Shailee S. Shah ◽  
Marie F. Grill
Keyword(s):  
Cerebrospinal Fluid ◽  
Short Term Memory ◽  
White Blood Cells ◽  
Memory Loss ◽  
Autoimmune Encephalitis ◽  
Complete Recovery ◽  
Aspartate Receptor ◽  
Normal Glucose ◽  
Disorganized Speech ◽  
Patient’S History

A 24-year-old woman sought care for 2 weeks of disorientation and short-term memory difficulties, as well as diffuse tremor of all extremities. She returned with further decline in memory and new severe headaches. She had intermittent agitation and emotional outbursts of crying or laughing, insomnia, spells consisting of disorganized speech and episodes of intermittent right gaze deviation with facial twitching and lip smacking. She was nearly mute. Her appetite had decreased and she had not had a bowel movement in several days. She was noted to have significant tachycardia and was intermittently febrile. Within several days she became unresponsive to all external stimuli, with nonpurposeful eye movements and frequent dyskinesias observed, and ultimately required ventilator support. Testing of the cerebrospinal fluid showed 236 white blood cells/µL, mildly increased protein concentration of 50 mg/dL, and normal glucose values. Electroencephalography initially demonstrated generalized slowing and generalized periodic epileptiform discharges and was also notable for an extreme delta brush pattern. Bilateral ovarian masses were identified on pelvic ultrasonography, and subsequent computed tomography of the abdomen and pelvis showed bilateral teratomas. An autoimmune encephalitis autoantibody panel was positive for antibodies targeting the N-methyl-d-aspartate receptor in the serum and cerebrospinal fluid, by both cell-based and immunofluorescence assays. The patient was diagnosed with anti- N-methyl-d-aspartate receptor encephalitis. The patient initially received intravenous methylprednisolone, followed by intravenous immunoglobulin. Benzodiazepines and propranolol were used to manage agitation and dysautonomia. Antiepileptic drugs were initiated for seizures. She required mechanical ventilation and parenteral nutrition given her persistent profound encephalopathic state. She underwent left ovarian cystectomy and right salpingo-oophorectomy. This patient’s history highlights the progressive clinical features characteristic of anti- N-methyl-d-aspartate receptor encephalitis and the long but often complete or near-complete recovery.

Diagnosis of cerebral hemorrhage before the era of computed tomography

2013 ◽  
Vol 154 (44) ◽  
pp. 1743-1746
Author(s):  
Gergely Hofgárt ◽  
Rita Szepesi ◽  
Bertalan Vámosi ◽  
László Csiba
Keyword(s):  
Computed Tomography ◽  
Cerebrospinal Fluid ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Hemorrhagic Stroke ◽  
Cranial Computed Tomography ◽  
Cerebral Stroke ◽  
Daily Routine ◽  
Stroke Patients ◽  
The Difference

Introduction: During the past decades there has been a great progress in neuroimaging methods. Cranial computed tomography is part of the daily routine now and its use allows a fast diagnosis of parenchymal hemorrhage. However, before the availability of computed tomography the differentiation between ischemic and hemorrhagic stroke was based on patient history, physical examination, percutan angiography and cerebrospinal fluid sampling, and the clinical utility could be evaluated by autopsy of deceased patients. Aim: The authors explored the diagnostic performance of cerebrospinal fluid examination for the diagnosis of ischemic and hemorrhagic stroke. Method: Data of 200 deceased stroke patients were retrospectively evaluated. All patients had liquor sampling at admission and all of them had brain autopsy. Results: Bloody or yellowish cerebrospinal fluid at admission had a positive predictive value of 87.5% for hemorrhagic stroke confirmed by autopsy, while clear cerebrospinal fluid had positive predictive value of 90.7% for ischemic stroke. Patients who had clear liquor, but autopsy revealed hemorrhagic stroke had higher protein level in the cerebrospinal fluid, but the difference was not statistically significant (p = 0.09). Conclusions: The results confirm the importance of pathological evaluation of the brain in cases deceased from cerebral stroke. With this article the authors wanted to salute for those who contributed to the development of the Hungarian neuropathology. In this year we remember the 110th anniversary of the birth, and the 60th anniversary of the death of professor Kálmán Sántha. Professor László Molnár would be 90 years old in 2013. Orv. Hetil., 154 (44), 1743–1746.

scholarly journals T cell acute lymphoblastic leukaemia presenting with sudden onset right oculomotor nerve palsy with normal neuroradiography and cerebrospinal fluid studies

2012 ◽  
Vol 2012 (mar26 1) ◽  
pp. bcr0120125685-bcr0120125685
Author(s):  
V. R. Bhatt ◽  
M. Naqi ◽  
R. Bartaula ◽  
S. Murukutla ◽  
S. Misra ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
T Cell ◽  
Acute Lymphoblastic Leukaemia ◽  
Lymphoblastic Leukaemia ◽  
Nerve Palsy ◽  
Sudden Onset ◽  
Oculomotor Nerve ◽  
Oculomotor Nerve Palsy

scholarly journals Characterization of a Subtype of Autoimmune Encephalitis With Anti–Contactin-Associated Protein-like 2 Antibodies in the Cerebrospinal Fluid, Prominent Limbic Symptoms, and Seizures

2016 ◽  
Vol 73 (9) ◽  
pp. 1115 ◽  
Author(s):  
Bastien Joubert ◽  
Margaux Saint-Martin ◽  
Nelly Noraz ◽  
Géraldine Picard ◽  
Veronique Rogemond ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Autoimmune Encephalitis

scholarly journals Six autoantibodies associated with autoimmune encephalitis are not detectable in the cerebrospinal fluid of suicide attempters

PLoS ONE ◽  
2017 ◽  
Vol 12 (4) ◽  
pp. e0176358 ◽  
Author(s):  
Johan Fernström ◽  
Åsa Westrin ◽  
Cécile Grudet ◽  
Lil Träskman-Bendz ◽  
Lena Brundin ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Autoimmune Encephalitis ◽  
Suicide Attempters

scholarly journals Isolated velopalatine paralysis associated with parvovirus B19 infection

2006 ◽  
Vol 64 (3a) ◽  
pp. 603-605 ◽  
Author(s):  
João P. Soares-Fernandes ◽  
Ricardo Maré
Keyword(s):  
Cerebrospinal Fluid ◽  
Nerve Palsy ◽  
Parvovirus B19 ◽  
Brain Mri ◽  
Sudden Onset ◽  
Recent Infection ◽  
Positive Data ◽  
Cerebrospinal Fluid Examination ◽  
Parvovirus B19 Infection

A case of isolated velopalatine paralysis in an 8-year-old boy is presented. The symptoms were sudden-onset of nasal speech, regurgitation of liquids into the nose and dysphagia. Brain MRI and cerebrospinal fluid examination were normal. Infectious serologies disclosed an antibody arrangement towards parvovirus B19 that was typical of recent infection. In the absence of other positive data, the possibility of a correlation between the tenth nerve palsy and parvovirus infection is discussed.

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