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Isolating Central Nervous System Tissues and Associated Meninges for the Downstream Analysis of Immune cells
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[Crossed central neuropathic pain syndrome after bacterial meningoencephalitis]

K Henkel1, D Bengel

  • 1Neurologische Poliklinik, Universität Ulm.

Schmerz (Berlin, Germany)
|February 16, 2005
PubMed

Insights

A rare case of bacterial meningoencephalitis following cervical myelography caused by Streptococcus acidominimus led to central neuropathic pain. Effective pain management involved gabapentin and amitriptyline, not opioids.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Neuroscience

Background:

  • Cervical myelography is an imaging procedure that carries a risk of complications.
  • Bacterial meningoencephalitis is a severe infection of the brain and its surrounding membranes.

Observation:

  • A 48-year-old female developed bacterial meningoencephalitis after cervical myelography.
  • Cerebrospinal fluid analysis revealed elevated cell counts and Streptococcus acidominimus.
  • Cranial MRI showed disseminated lesions in the brainstem and thalamus.

Findings:

  • The patient presented with a crossed central neuropathic pain syndrome.
  • Neurological examination identified mechanical allodynia, hyperpathy, and neuropathic facial pain.
  • A medullary lesion, likely affecting the spinal trigeminal and spinothalamic tracts, was identified on MRI.

Implications:

  • This case highlights a rare but serious complication of cervical myelography.
  • Understanding the neuroanatomical basis of pain is crucial for effective treatment.
  • Combination therapy with gabapentin and amitriptyline proved effective for neuropathic pain, outperforming opioids.

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