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Influenza B-induced longitudinally extensive transverse myelitis and bithalamic acute disseminated encephalomyelitis

Naomi Geurs1,2, Kathleen Hoffbauer1,2, An Belmans3

  • 1Department of Neurology, Geel General Hospital, Ziekenhuis Netwerk Kempen, Ziekenhuis Geel, JB Stessenstraat 2, 2440, Geel, Belgium.

Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
|October 17, 2023
PubMed

Insights

Influenza B infection can trigger acute disseminated encephalomyelitis (ADEM), a rare autoimmune disorder affecting the central nervous system (CNS). This case highlights a unique presentation of ADEM following influenza B, leading to severe neurological symptoms.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Immunology

Background:

  • Influenza B virus remains an endemic pathogen with potential for rare central nervous system (CNS) complications.
  • The COVID-19 pandemic has led to reduced scientific focus on other viral pathogens like influenza.
  • Post-infectious neurological syndromes, particularly those triggered by influenza, warrant continued investigation.

Observation:

  • A 35-year-old male presented with a week-long fever, progressing to acute ascending flaccid paralysis and urinary retention.
  • Diagnostic evaluations, including lumbar puncture and full spine MRI, confirmed longitudinally extensive transverse myelitis (LETM).
  • Brain MRI revealed bilateral thalamic necrotizing encephalopathy.

Findings:

  • The patient's clinical presentation and diagnostic findings were consistent with influenza B-induced acute disseminated encephalomyelitis (ADEM).
  • The co-occurrence of LETM and necrotizing encephalopathy in the thalamus represented a unique, autoimmune-mediated, monophasic CNS disorder.
  • The diagnosis was strongly linked to a preceding influenza type B infection.

Implications:

  • This case underscores the potential for influenza B to trigger severe and complex autoimmune neurological conditions like ADEM.
  • Recognizing influenza-induced ADEM is crucial for timely diagnosis and management of CNS inflammatory disorders.
  • Further research into influenza-associated neurological complications can improve understanding and patient outcomes.
Keywords:
EncephalitisInfluenzaNecrotizing encephalopathyThalamusTransverse myelitis

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