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Acute disseminated encephalomyelitis following aseptic meningoencephalitis

S Shintani1, Y Fumimura, T Shiigai

  • 1Department of Neurology, Toride Kyodo General Hospital, 2-1-1 Hongoh, Toride City, 302-0022, Ibaraki, Japan. dw4s-sntn@asahi-net.or.jp

Clinical Neurology and Neurosurgery
|September 5, 2001
PubMed

Insights

A previously healthy man experienced aseptic meningoencephalitis, followed by ataxia and psychiatric symptoms. Steroid therapy rapidly resolved these neurological issues and brain lesions.

Area of Science:

  • Neurology
  • Neuroimmunology
  • Infectious Diseases

Background:

  • Aseptic meningoencephalitis is an inflammatory condition affecting the brain and meninges.
  • Early diagnosis and treatment are crucial for managing neurological disorders.

Observation:

  • A 50-year-old man presented with acute aseptic meningoencephalitis, exhibiting fever, headache, seizure, Wernicke aphasia, hemiplegia, and blindness.
  • Post-remission, he developed significant ataxia and psychiatric symptoms.
  • MRI revealed new lesions in the basal ganglia, thalamus, white matter, and cerebellum.
  • Cerebrospinal fluid showed elevated myelin basic protein despite overall improvement.

Findings:

  • Steroid therapy led to a rapid and dramatic resolution of ataxic symptoms and disseminated brain lesions.
  • Elevated myelin basic protein in cerebrospinal fluid may indicate ongoing demyelination or inflammation.

Implications:

  • This case highlights the potential for delayed neurological complications following aseptic meningoencephalitis.
  • Early and aggressive treatment with corticosteroids can be effective in managing severe neurological sequelae.
  • Myelin basic protein levels may serve as a biomarker for treatment response in such conditions.

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