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Encephalitis l: Introduction

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Encephalitis is inflammation of the brain parenchyma, most often due to infections or autoimmune processes. It presents with neuropsychiatric features such as fever, altered mental status, behavioral changes, cognitive dysfunction, seizures, focal deficits, and sometimes autonomic instability. In some cases, the meninges are also involved, resulting in meningoencephalitis.Infectious CausesInfectious encephalitis is most commonly viral but can also result from bacterial, fungal, or parasitic...

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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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A Murine Model of Dengue Virus-induced Acute Viral Encephalitis-like Disease

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Published on: April 28, 2019

Acute hemorrhagic leukoencephalitis with atypical features.

Mauro Catalan¹, Marcello Naccarato, Fabio Chiodo Grandi

¹Department of Clinical Medicine and Neurology, Azienda Ospedaliera-Universitaria Ospedali Riuniti di Trieste, University of Trieste, Strada di Fiume, 447, 34149 Trieste, Italy. maurocatalan@libero.it

Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology

|January 16, 2009

Summary

Acute hemorrhagic leukoencephalitis (AHL), a rare pediatric demyelinating disease, occurred in a 62-year-old man post-pneumonia. Prompt treatment led to partial recovery, highlighting atypical presentations and management challenges.

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Area of Science:

Neurology
Immunology
Infectious Diseases

Background:

Acute hemorrhagic leukoencephalitis (AHL) is a rare, severe demyelinating disorder typically affecting children.
Characterized by rapid onset, progressive neurological decline, and high mortality rates.
Adult-onset AHL is exceptionally rare, posing diagnostic challenges.

Observation:

A 62-year-old male presented with diplopia and ataxia following pneumonia.
Initial MRI revealed brainstem hyperintensities; serology showed Mycoplasma Pneumoniae antibodies and cold agglutinins.
Clinical deterioration included hemiplegia, seizures, and coma, with subsequent MRI showing extensive white matter lesions and hemorrhage.

Findings:

The patient's presentation and neuroimaging findings were consistent with adult-onset AHL.
Treatment involved Aciclovir, steroids, and plasmapheresis.
Partial neurological recovery was observed after a prolonged coma, with persistent hemiplegia.

Implications:

This case expands the known demographic of AHL to include older adults.
It underscores the importance of considering AHL in adult neurological emergencies, especially post-infectious.
Early diagnosis and multimodal treatment may improve outcomes in this rare condition.