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Encephalitis ll: Pathophysiology01:26

Encephalitis ll: Pathophysiology

Encephalitis is inflammation of the brain parenchyma caused by direct viral invasion or immune-mediated mechanisms triggered by infections or tumors. Both processes lead to neuronal injury, disrupted neurotransmission, and diverse neurological symptoms, often with overlapping clinical and pathological features.Autoimmune EncephalitisIn autoimmune encephalitis, antibodies target neuronal antigens on cell surfaces, synapses, or within neurons. A key example is anti-NMDAR encephalitis, which can...
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Bacterial meningitis typically begins when pathogens such as Neisseria meningitidis and Streptococcus pneumoniae colonize the nasopharynx and invade the bloodstream. This process is facilitated by bacterial virulence factors, such as polysaccharide capsules, which resist phagocytosis and complement-mediated killing. Less commonly, bacteria reach the central nervous system via contiguous spread from infections like otitis media or sinusitis, through congenital or acquired dural defects, or...
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The disease process of myasthenia gravis begins at the neuromuscular junction, where antibodies attack key proteins needed for muscle activation. This immune reaction weakens signal transmission, leading to the characteristic muscle fatigue and weakness that define the condition.Immune-Mediated DamageIn most individuals, antibodies target acetylcholine receptors (AChRs) on the postsynaptic membrane of muscle cells. By blocking acetylcholine binding, these antibodies prevent the nerve signal...
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Induction of Experimental Autoimmune Encephalomyelitis in Mice and Evaluation of the Disease-dependent Distribution of Immune Cells in Various Tissues
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[VZV-related myelitis: a pathophysiological hypothesis].

O Outteryck1, V Deramecourt, S Bombois

  • 1Clinique Neurologique, Hôpital Roger Salengro, CHRU de Lille, 59037 Lille Cedex.

Revue Neurologique
|February 17, 2007
PubMed
Summary

Varicella zoster virus (VZV) infection can cause myelitis, a rare spinal cord inflammation. Early diagnosis and combined treatment with acyclovir and corticosteroids improve outcomes for VZV-related myelitis.

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Isolating Central Nervous System Tissues and Associated Meninges for the Downstream Analysis of Immune cells

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Immunology

Background:

  • Complications of Varicella Zoster Virus (VZV) infection in the central nervous system are diverse.
  • VZV-related myelitis, a rare complication of herpes zoster, presents diagnostic and therapeutic challenges.

Observation:

  • A 55-year-old man with intercostal herpes zoster developed subacute medullar syndrome.
  • MRI revealed extensive cervico-thoracic spinal cord hyperintensity on T2-weighted images.
  • Cerebrospinal fluid analysis showed pleocytosis, elevated protein, negative VZV PCR, and positive anti-VZV IgG, supporting VZV myelitis.

Findings:

  • The case presented three potential pathophysiological mechanisms: infectious, immune post-infectious, and vascular.
  • The patient experienced a partially favorable outcome after a short course of corticosteroids and prolonged acyclovir infusion.
  • This case highlights the potential vascular tropism of VZV, suggesting a more severe prognosis.

Implications:

  • Early diagnosis of VZV-related myelitis is crucial for timely intervention.
  • Combination therapy with acyclovir and corticosteroids appears beneficial for managing VZV myelitis.
  • Understanding VZV's vascular tropism may guide future treatment strategies and prognostic assessments.