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brainstem encephalitis

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https://www.readbyqxmd.com/read/29440480/trismus-caused-by-paraneoplastic-brainstem-encephalitis
#1
Naveed Malek, Maxwell Damian
We discuss the assessment and differential diagnoses of a middle-aged man who presented with trismus, double vision and behavioural problems. MRI scan of the brain was initially normal, but a month later showed high signal in the hippocampal region on fluid attenuated inversion recovery sequence (FLAIR) imaging. We suspected a paraneoplastic brainstem encephalitis because of his smoking history, rapidly progressive symptoms and abnormal brainstem signs. A positron emission tomography-CT scan identified abnormal subcarinal nodes, shown on biopsy to be metastatic small cell lung cancer...
February 13, 2018: Practical Neurology
https://www.readbyqxmd.com/read/29366609/surgical-treatment-of-enterovirus-d68-brainstem-encephalitis-induced-dysphagia
#2
Takafumi Togashi, Hironori Baba, Meiko Kitazawa, Nao Takahashi, Yasuhiro Samejima, Eiji Yumoto, Arata Horii
Cluster of acute flaccid paralysis and cranial nerve dysfunction was associated with a 2014 outbreak of enterovirus D68 (EV-D68) respiratory illness in US. We describe a 33 year-old male patient of refractory dysphagia due to EV-D68-induced brainstem encephalitis successfully treated by surgery. Following acute upper respiratory tract infection, he developed dysphagia and bilateral facial paralysis. A coughing reflex was readily produced when the laryngopharyngeal fiberscope touched the epiglottis, however, water infusion induced only very weak and slow swallowing reflex, suggesting that only motor component was impaired but sensory function was preserved during swallowing...
January 20, 2018: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/29352287/ifn%C3%AE-inhibits-g-csf-induced-neutrophil-expansion-and-invasion-of-the-cns-to-prevent-viral-encephalitis
#3
Chandran Ramakrishna, Edouard M Cantin
Emergency hematopoiesis facilitates the rapid expansion of inflammatory immune cells in response to infections by pathogens, a process that must be carefully regulated to prevent potentially life threatening inflammatory responses. Here, we describe a novel regulatory role for the cytokine IFNγ that is critical for preventing fatal encephalitis after viral infection. HSV1 encephalitis (HSE) is triggered by the invasion of the brainstem by inflammatory monocytes and neutrophils. In mice lacking IFNγ (GKO), we observed unrestrained increases in G-CSF levels but not in GM-CSF or IL-17...
January 19, 2018: PLoS Pathogens
https://www.readbyqxmd.com/read/29338930/neurologic-disorders-associated-with-anti-glutamic-acid-decarboxylase-antibodies-a-comparison-of-anti-gad-antibody-titers-and-time-dependent-changes-between-neurologic-disease-and-type-i-diabetes-mellitus
#4
Hideto Nakajima, Yoshitsugu Nakamura, Yuiko Inaba, Chiharu Tsutsumi, Kiichi Unoda, Takafumi Hosokawa, Fumiharu Kimura, Toshiaki Hanafusa, Masamichi Date, Haruko Kitaoka
To determine clinical features of neurologic disorders associated with anti-glutamic acid decarboxylase antibodies (anti-GAD-Ab), we examined titers and time-dependent changes of anti-GAD-Ab. Six patients, stiff person syndrome (2), cerebellar ataxia (1), limbic encephalitis (1), epilepsy (1), brainstem encephalitis (1), were compared with 87 type I diabetes mellitus (T1DM) patients without neurologic disorders. Anti-GAD-Ab titers and index were higher in neurologic disorders than in T1DM, suggesting intrathecal antibody synthesis...
January 9, 2018: Journal of Neuroimmunology
https://www.readbyqxmd.com/read/29335082/-a-comparative-analysis-of-anti-n-methyl-d-aspartate-receptor-encephalitis-with-or-without-abnormal-findings-on-cranial-magnetic-resonance-imaging
#5
Jian-Zhao Zhang, Qian Chen, Ping Zheng, Li-Na Xie, Xiao-Li Yi, Hai-Tao Ren, Jian Yang
OBJECTIVE: To investigate the clinical features of children with anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis with normal or abnormal cranial magnetic resonance imaging (MRI) findings via a comparative analysis. METHODS: A retrospective analysis was performed for the clinical data of 33 children with anti-NMDAR encephalitis. The clinical features and prognosis were compared between the children with normal and abnormal cranial MRI findings. RESULTS: In the 33 children with anti-NMDAR encephalitis, the most common initial symptoms were seizures (61%) and involuntary movement (61%), followed by language disorder (54%), mental and behavioral abnormalities (52%), and disturbance of consciousness (30%)...
January 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/29243130/neuroleptic-malignant-syndrome-as-a-presenting-feature-of-subacute-sclerosing-panencephalitis
#6
Divyani Garg, Varun Reddy, Rajesh Kumar Singh, Deepa Dash, Rohit Bhatia, Manjari Tripathi
Subacute sclerosing panencephalitis (SSPE) is a slowly progressive degenerative disorder caused by measles virus. It is characterised by typical clinical and electrophysiological features in the form of slow myoclonic jerks, with progressive cognitive impairment, visual symptoms, and periodic complexes on EEG, with raised titres of anti-measles antibodies in CSF and serum. Atypical presentations of SSPE have been reported including brainstem involvement, ADEM-like presentation, acute encephalitis, and cerebellar ataxia...
February 2018: Journal of Neurovirology
https://www.readbyqxmd.com/read/29233145/suppression-of-interleukin-6-increases-enterovirus-a71-lethality-in-mice
#7
Li-Chiu Wang, Hui-Wen Yao, Chuan-Fa Chang, Shainn-Wei Wang, Shih-Min Wang, Shun-Hua Chen
BACKGROUND: Enterovirus A71 (EV-A71) infection can induce fatal encephalitis in young children. Clinical reports show that interleukin-6 (IL-6) levels in the serum and cerebrospinal fluid of infected patients with brainstem encephalitis are significantly elevated. We used a murine model to address the significance of endogenous IL-6 in EV-A71 infection. RESULTS: EV-A71 infection transiently increased serum and brain IL-6 protein levels in mice. Most importantly, absence of IL-6 due to gene knockout or depletion of IL-6 using neutralizing monoclonal antibody enhanced the mortality and tissue viral load of infected mice...
December 12, 2017: Journal of Biomedical Science
https://www.readbyqxmd.com/read/29177548/pediatric-bickerstaff-brainstem-encephalitis-a-systematic-review-of-literature-and-case-series
#8
Jonathan Douglas Santoro, Daniel V Lazzareschi, Cynthia Jane Campen, Keith P Van Haren
OBJECTIVE: To characterize the phenotype of pediatric Bickerstaff's brainstem encephalitis (BBE) and evaluate prognostic features in the clinical course, diagnostic studies, and treatment exposures. METHODS: We systematically reviewed PubMed, Web of Science, and SCOPUS databases as well as medical records at the Lucile Packard Children's Hospital to identify cases of pediatric BBE. Inclusion required all of the following criteria: age ≤ 20 years, presence of somnolence or alterations in mental status at the time of presentation or developed within 7 days of presentation, ataxia, and ophthalmoplegia...
November 24, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/29141829/cerebral-cortical-encephalitis-followed-by-recurrent-cns-demyelination-in-a-patient-with-concomitant-anti-mog-and-anti-nmda-receptor-antibodies
#9
Lei Zhou, Jingzi ZhangBao, Haiqing Li, Xiaoyang Li, Yongheng Huang, Min Wang, Chongbo Zhao, Jiahong Lu, Chuanzhen Lu, Yuxin Li, Chao Quan
We report the case of a patient who initially presented with fever, headache and seizure. MRI revealed a fluid attenuation inversion recovery (FLAIR) high-intensity lesion involving the right temporal, parietal and occipital cortex. Afterwards, the patient developed three recurrent episodes, manifested as brainstem encephalitis, optic neuritis and ADEM-like illness successively, indicating demyelination. Both of his serum anti-MOG and CSF anti-NMDAR antibodies were proved positive by transfected cell based assays...
November 2017: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/29110767/cerebrospinal-fluid-findings-in-guillain-barr%C3%A3-syndrome-and-chronic-inflammatory-demyelinating-polyneuropathies
#10
Zsolt Illes, Morten Blaabjerg
The classic immunologic alteration of the cerebrospinal fluid (CSF) in Guillain-Barré syndrome (GBS), albuminocytologic dissociation, has been known since the original paper by Guillain, Barré, and Strohl. Albuminocytologic dissociation has been also described in other forms of the GBS spectrum, such as axonal motor or motor-sensory forms (AMAN, AMSAN), the anti-GQ1b spectrum of Miller Fisher syndrome, and Bickerstaff brainstem encephalitis. Cytokines, chemokines, antibodies, complement components, and molecules with a putative neuroprotective role or indicating axonal damage have also been examined using different methods...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/29065229/prediction-of-disease-progression-in-miller-fisher-and-overlap-syndromes
#11
Christine Verboon, Heleen van Berghem, Pieter A van Doorn, Liselotte Ruts, Bart C Jacobs
BACKGROUND: Patients with Miller Fisher syndrome (MFS) may have a relatively mild clinical course or progress to Guillain-Barré syndrome with limb weakness (MFS-GBS overlap syndrome). Other variants in this spectrum are GBS with ophthalmoparesis and Bickerstaff's Brainstem encephalitis (BBE). AIM: To compare the clinical course of MFS and overlap syndromes and to identify predictors of disease progression. METHODS: In a prospective study of 170 patients with GBS and variant forms, 37 (22%) had a MFS, MFS-GBS overlap syndrome, ophthalmoplegic GBS or BBE...
October 24, 2017: Journal of the Peripheral Nervous System: JPNS
https://www.readbyqxmd.com/read/29062233/sporadic-hyperekplexia-due-to-self-limiting-brainstem-encephalopathy
#12
Dilek Yilmaz, Bülent Cengiz
Hyperekplexia is a rare movement disorder characterized by pathologically exaggerated response to unexpected stimuli. It is differentiated from the normal startle reflex by its lower threshold, higher intensity, and resistance to habituation. Many of the acquired hyperekplexias result from brainstem involvement such as encephalitis, infarct, hemorrhage, pontocerebellar hypoplasia and medullary compression. This case report depicts a rare manifestation of hyperekplexia. The unusual aspect of this case was the vocalization that was reproduced in response to startling stimuli...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/29050838/three-children-of-meningoencephalitis-with-kikuchi-necrotizing-lymphadenitis
#13
Joung-Hee Byun, Su Eun Park, Sang Ook Nam, Young A Kim, Young Mi Kim, Gyu Min Yeon, Yun-Jin Lee
BACKGROUND: Kikuchi necrotizing lymphadenitis (KNL) is a rare and benign cause of lymphadenopathy, most often cervical. The etiology of KNL remains unknown. Central nervous system (CNS) involvement, such as in meningoencephalitis, is a very rare clinical manifestation of KNL, especially in children. CASE REPORTS: A 12-year-old boy presented with unilateral cervical lymphadenopathy and fever. Histopathological findings led to the diagnosis of KNL. He revisited due to severe headache and vomiting one week later...
October 16, 2017: Brain & Development
https://www.readbyqxmd.com/read/29049234/case-report-features-of-hand-foot-and-mouth-disease-in-neonates
#14
Wen-Wen Chen, Zhao-Bin Yang, Lian-Shu Lian, Li-Ping Xu
RATIONALE: Hand, foot and mouth disease (HFMD) is caused by enterovirus. The virus may exist in secretions. PATIENT CONCERNS: Five neonates had symptoms of fever and maculopapular rashes involving face, trunk, breech, arms, and legs, especially scattering on palms and feet. Blood, oropharyngeal fluid, urine, and cerebrospinal fluid (CSF) samples were collected and detected for further diagnoses with the consent of the infants' parents. Some of them suffered aseptic meningitis...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28905216/slowly-progressing-varicella-zoster-brainstem-encephalitis-complicating-ramsay-hunt-syndrome-in-an-immunocompetent-patient-case-report-and-review-of-the-literature
#15
Vito A G Ricigliano, Lorenzo Saraceno, Michele Cavalli, Mariaemma Rodegher, Giovanni Meola
A 56-year-old immunocompetent male developed brainstem encephalitis complicating Ramsay Hunt syndrome. The disease had a slowly progressing course of months after the triggering infection, much longer than previously reported. Furthermore, magnetic resonance imaging, physical-chemical, and cell count analyses on cerebrospinal fluid were normal, whereas polymerase chain reaction for varicella zoster virus DNA was positive. The simultaneous negativity of both imaging and basic CSF exams is very rare, although possible event which confirms the irreplaceable role of viral screening on CSF...
September 13, 2017: Journal of Neurovirology
https://www.readbyqxmd.com/read/28899886/brainstem-encephalitis-and-acute-polyneuropathy-associated-with-hepatitis-e-infection
#16
Omar Jabbar Salim, Amy Davidson, Kathy Li, John Paul Leach, Craig Heath
A 59-year-old man presented with feverish illness. His Glasgow Coma Scale was 15, had reduced visual acuity in the left eye with partial left ptosis and mild left hemiparesis with an extensor left plantar. Over 48 hours, he accrued multiple cranial nerves palsies and progressed to a flaccid paralysis necessitating admission to an intensive care unit.Cerebrospinal fluid (CSF) study showed 20 lymphocytes and raised protein. Viral and bacterial PCRs were negative. Samples for Lyme, blood-borne viruses, syphilis and autoantibodies were also negative...
September 11, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28895082/clinical-manifestations-and-treatment-outcomes-of-parvovirus-b19-encephalitis-in-immunocompetent-adults
#17
Jin-Sun Jun, Jangsup Moon, Jung-Ick Byun, Jun-Sang Sunwoo, Jung-Ah Lim, Soon-Tae Lee, Keun-Hwa Jung, Kyung-Il Park, Ki-Young Jung, Manho Kim, Sang Kun Lee, Kon Chu
Parvovirus B19 (PVB19) has rarely been identified as a cause of encephalitis in immunocompetent adults, in whom clinical information regarding PVB19 encephalitis has remained unclear. Herein, we report the clinical presentations, laboratory and imaging findings, and treatment outcomes of five immunocompetent adults with PVB19 encephalitis. Although none of the patients showed any distinctive features of PVB19 infection, they showed various clinical manifestations, including one instance of brainstem involvement...
December 2017: Journal of Neurovirology
https://www.readbyqxmd.com/read/28888467/early-electrophysiological-findings-in-fisher-bickerstaff-syndrome
#18
M A Alberti, M Povedano, J Montero, C Casasnovas
INTRODUCTION: The term Fisher-Bickerstaff syndrome (FBS) has been proposed to describe the clinical spectrum encompassing Miller-Fisher syndrome (MFS) and Bickerstaff brainstem encephalitis. The pathophysiology of FBS and the nature of the underlying neuropathy (demyelinating or axonal) are still subject to debate. This study describes the main findings of an early neurophysiological study on 12 patients diagnosed with FBS. PATIENTS AND METHODS: Retrospective evaluation of clinical characteristics and electrophysiological findings of 12 patients with FBS seen in our neurology department within 10 days of disease onset...
September 6, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/28878050/antibody-associated-cns-syndromes-without-signs-of-inflammation-in-the-elderly
#19
Domingo Escudero, Mar Guasp, Helena Ariño, Carles Gaig, Eugenia Martínez-Hernández, Josep Dalmau, Francesc Graus
OBJECTIVE: To report the CNS syndromes of patients ≥60 years of age with antibodies against neuronal surface antigens but no evidence of brain MRI and CSF inflammatory changes. METHODS: This was a retrospective clinical analysis of patients with antibodies against neuronal surface antigens who fulfilled 3 criteria: age ≥60 years, no inflammatory abnormalities in brain MRI, and no CSF pleocytosis. Antibodies were determined with reported techniques. RESULTS: Among 155 patients ≥60 years of age with neurologic syndromes related to antibodies against neuronal surface antigens, 35 (22...
October 3, 2017: Neurology
https://www.readbyqxmd.com/read/28829730/clinical-characteristics-of-severe-japanese-encephalitis-a-case-series-from-south-korea
#20
Jun-Sang Sunwoo, Soon-Tae Lee, Keun-Hwa Jung, Kyung-Il Park, Jangsup Moon, Ki-Young Jung, Manho Kim, Sang Kun Lee, Kon Chu
Japanese encephalitis (JE) virus is a major cause of devastating viral encephalitis, especially in Asia. Although a successful vaccination program led to its near-elimination over three decades in South Korea, the incidence of JE has increased since 2010. The present study investigated the clinical manifestations, laboratory findings, and factors affecting neurological outcomes of reemerging JE. We retrospectively reviewed medical records of laboratory-confirmed JE patients who presented with acute encephalitis syndrome at three tertiary hospitals between 2010 and 2015...
August 2017: American Journal of Tropical Medicine and Hygiene
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