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A case of enteroviral meningoencephalitis presenting as rapidly progressive dementia

Victor Valcour1, Aissa Haman, Susannah Cornes

  • 1Department of Neurology, Memory and Aging Center, University of California, San Francisco, CA94143, USA. vvalcour@memory.ucsf.edu

Nature Clinical Practice. Neurology
|May 15, 2008
PubMed
Abstract

Insights

This case study highlights enteroviral meningoencephalitis in an immunocompetent adult, presenting with cognitive decline and neurological symptoms. Prompt diagnosis and treatment with immunotherapy are crucial for managing this rare neurological infection.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Neuroimmunology

Background:

  • A 70-year-old male presented with a 7-month history of somatic complaints followed by progressive cognitive and behavioral decline.
  • Initial assessments for infectious etiology were inconclusive, despite noted cerebrospinal fluid pleocytosis.

Observation:

  • The patient exhibited disorientation, distractibility, inappropriate laughter, and deficits in following commands.
  • Neurological examination revealed hypophonic speech and increased axial tone, with a severely impaired Mini Mental State Examination score.

Findings:

  • Diagnosis of enteroviral meningoencephalitis was established through cerebrospinal fluid analysis and RNA sequencing of brain biopsy samples.
  • Enterovirus group-specific reverse transcriptase polymerase chain reaction assay confirmed the presence of enteroviral infection.

Implications:

  • This case underscores the importance of considering enteroviral meningoencephalitis in adults presenting with subacute cognitive decline and neurological abnormalities.
  • Intravenous steroids and immunoglobulin therapy represent a potential management strategy for this condition.

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