BACKGROUND Anti-leucine-rich glioma inactivated protein 1(anti-LGI1) encephalitis is an infrequent type of autoimmune encephalitis(AE) characterized by acute or subacute cognitive and psychiatric disturbance, facio-br...BACKGROUND Anti-leucine-rich glioma inactivated protein 1(anti-LGI1) encephalitis is an infrequent type of autoimmune encephalitis(AE) characterized by acute or subacute cognitive and psychiatric disturbance, facio-brachial dystonic seizures(FBDSs), and hyponatremia. Anti-LGI1 AE has increasingly been considered a primary form of AE. Early identification and treatment of this disease are clearly very important.CASE SUMMARY Here, we report that a male patient developed severe anti-LGI1 encephalitis, which was initially misdiagnosed as a sleep disturbance. He was hospitalized for epileptic seizures and typical FBDSs half a month after he developed sleep disturbances. LGI1 antibodies were detected in his cerebrospinal fluid and serum(1:100 and 1:3.2, respectively), which led to the diagnosis of classic anti-LGI1 AE. No obvious abnormality was observed on brain computed tomography images. T2-weighted fluid-attenuated inversion recovery and T2-weighted scans of brain magnetic resonance imaging(MRI) showed slightly elevated signals within the left basal ganglia area. No tumor was detected within the brain of this patient using MRI. After hormone and antiepileptic drug treatment, the patient’s symptoms improved significantly.CONCLUSION Anti-LGI1 antibody-associated encephalitis has characteristic clinical manifestations, such as cognitive impairment, psychiatric symptoms, seizures, sleep disorders, hyponatremia, and FBDSs. LGI1 antibodies are present in the serum and/or cerebrospinal fluid, but their production is sensitive to immunosuppressants, and this disease has a relatively good prognosis. In particular, we should be aware of the possibility of anti-LGI1 antibody-associated encephalitis in adolescents with sleep disorders to avoid missed diagnoses and misdiagnoses.展开更多
BACKGROUND It is not uncommon to develop autoimmune encephalitis and paraneoplastic neurological syndromes(PNS).4 kinds of antibody-positive autoimmune paraneoplastic limbic encephalitis(PLE)have not been reported.CAS...BACKGROUND It is not uncommon to develop autoimmune encephalitis and paraneoplastic neurological syndromes(PNS).4 kinds of antibody-positive autoimmune paraneoplastic limbic encephalitis(PLE)have not been reported.CASE SUMMARY PNS are distant effects of cancer on the nervous system,rather than syndromes in which cancer directly invades and metastasizes to the nerves and/or muscle tissues.If the limbic lobe system of the brain is involved,this will result in PLE.The detection of patients with PNS is challenging since tumors that cause paraneoplastic neurologic disorders are often asymptomatic,obscure,and thus easily misdiagnosed or missed.Currently,single-or double-antibody-positive paraneoplastic marginal encephalitis has been reported.However,no cases of three or more-antibody-positive cases have been reported.Here,we report a case of PLE that is anti-collapsing response-mediator protein-5,anti-neuronal nuclear antibody-type 1,anti-aminobutyric acid B receptor,and anti-glutamate deglutase positive,and address relevant literature to improve our understanding of the disease.CONCLUSION This article reports on the management of a case of PLE with four positive antibodies,a review of the literature,in order to raise awareness among clinicians.展开更多
Objective: To investigate the serum VCAM-1 content in children with viral encephalitis and its correlation with nerve injury and inflammatory response. Methods: A total of 60 children with viral encephalitis who were ...Objective: To investigate the serum VCAM-1 content in children with viral encephalitis and its correlation with nerve injury and inflammatory response. Methods: A total of 60 children with viral encephalitis who were treated in Xianyang First People's Hospital between December 2015 and January 2017 were selected as viral encephalitis group, and 50 healthy children who accepted vaccination in the hospital during the same period were selected as normal control group. The differences in serum levels of VCAM-1, nerve injury-related indexes and inflammatory factors were compared between two groups of children, and Pearson test was used to further evaluate the correlation of serum VCAM-1 content with nerve injury and inflammatory response in children with viral encephalitis. Results: Immediately after admission, serum VCAM-1 content of children with viral encephalitis was significantly higher than that of normal control group;serum nerve injury-related indexes CK-BB, MBP, β-EP and NSE contents were higher than those of normal control group;serum inflammatory factors IL-6, IL-18 and γ-IFN contents were higher than those of control group. Pearson test showed that serum VCAM-1 content in children with viral encephalitis was positively correlated with nerve injury and inflammatory response. Conclusion: Serum VCAM-1 content is high in children with viral encephalitis, and the specific content is directly correlated with the severity of nerve injury and inflammatory response.展开更多
Neurological manifestations in H1N1 influenza A infection are very rare, especially in adults, and its mechanism of action is still uncertain. Here, we reported the case of a 53-year-old woman with human immunodeficie...Neurological manifestations in H1N1 influenza A infection are very rare, especially in adults, and its mechanism of action is still uncertain. Here, we reported the case of a 53-year-old woman with human immunodeficiency virus infection (HIV) who had H1N1 influenza A pneumonia complicated with very rare acute necrotizing encephalitis, although the HIV was under control. With prompt identification and administration of high dosage of dexamethasone, her mental status improved from stupor to clear, with minimal right hemiparesis. Further, brain magnetic resonance image revealed great resolution of mass effect. This dramatic improvement in response to the treatment may improve our understanding of the pathophysiology between H1N1 influenza A infection and acute necrotizing encephalitis.展开更多
Objective: To explore the changes of MCP-1, FKN, and related cytokines in the serum and cerebrospinal fluid (CSF) in children with epidemic encephalitis B. Methods: A total of 40 children with epidemic encephalitis B ...Objective: To explore the changes of MCP-1, FKN, and related cytokines in the serum and cerebrospinal fluid (CSF) in children with epidemic encephalitis B. Methods: A total of 40 children with epidemic encephalitis B who were admitted in our hospital from June, 2014 to June, 2017 were included in the study and divided into the severe group (n=15) and general group (n=25) according to the severity group. Moreover, 20 children who were suffered from oblique inguinal hernia, perineal adhesion, and cryptorchidism were served as the control group. The serum and CSF specimens were collected 24 h after admission and during the recovery period in children with epidemic encephalitis B. The serum specimen was collected 24 h after admission in the control group, and CSF specimen was collected during the lumbar puncture. ELISA was used to detect CMP-1, FKN, IL-1β, IL-18, and TNF-α levels in the serum and CSF. CMP-1, FKN, IL-1β, IL-18, and TNF-α levels in children with epidemic encephalitis B on the day after admission and 2-3 weeks after admission and in the control group were compared. The changes of CMP-1, FKN, IL-1β, IL-18, and TNF-α in children with severe and general epidemic encephalitis B were observed. Results: CMP-1 and FKN levels in the serum and CSF in children with epidemic encephalitis B in the critical stage were significantly higher than those in the recovery stage and in the control group. The serum CMP-1 and FKN levels in children with epidemic encephalitis B during the recovery stage were not significantly different from those in the control group, while CMP-1 and FKN levels in CSF were significantly higher than those in the control group. CMP-1 and FKN levels in the serum and CSF in children with severe epidemic encephalitis B were significantly higher than those in the general group. IL-1β, TNF-α, and IL-18 levels in the serum and CSF in children with epidemic encephalitis B during the critical stage were significantly higher than those during the recovery stage and in the control group. IL-1β, TNF-α, and IL-18 levels in the serum and CSF in children with epidemic encephalitis B during the recovery stage were significantly higher than those in the control group. IL-1β, TNF-α, and IL-18 levels in the serum and CSF in children with severe epidemic encephalitis B were significantly higher than those in the general group. Conclusions: CMP-1, FKN, IL-1β, TNF-α, and IL-18 levels in the serum and CSF in children with epidemic encephalitis B are correlated with the severity degree, detection of which can contribute to estimate the clinical typing and condition change of epidemic encephalitis.展开更多
文摘BACKGROUND Anti-leucine-rich glioma inactivated protein 1(anti-LGI1) encephalitis is an infrequent type of autoimmune encephalitis(AE) characterized by acute or subacute cognitive and psychiatric disturbance, facio-brachial dystonic seizures(FBDSs), and hyponatremia. Anti-LGI1 AE has increasingly been considered a primary form of AE. Early identification and treatment of this disease are clearly very important.CASE SUMMARY Here, we report that a male patient developed severe anti-LGI1 encephalitis, which was initially misdiagnosed as a sleep disturbance. He was hospitalized for epileptic seizures and typical FBDSs half a month after he developed sleep disturbances. LGI1 antibodies were detected in his cerebrospinal fluid and serum(1:100 and 1:3.2, respectively), which led to the diagnosis of classic anti-LGI1 AE. No obvious abnormality was observed on brain computed tomography images. T2-weighted fluid-attenuated inversion recovery and T2-weighted scans of brain magnetic resonance imaging(MRI) showed slightly elevated signals within the left basal ganglia area. No tumor was detected within the brain of this patient using MRI. After hormone and antiepileptic drug treatment, the patient’s symptoms improved significantly.CONCLUSION Anti-LGI1 antibody-associated encephalitis has characteristic clinical manifestations, such as cognitive impairment, psychiatric symptoms, seizures, sleep disorders, hyponatremia, and FBDSs. LGI1 antibodies are present in the serum and/or cerebrospinal fluid, but their production is sensitive to immunosuppressants, and this disease has a relatively good prognosis. In particular, we should be aware of the possibility of anti-LGI1 antibody-associated encephalitis in adolescents with sleep disorders to avoid missed diagnoses and misdiagnoses.
文摘BACKGROUND It is not uncommon to develop autoimmune encephalitis and paraneoplastic neurological syndromes(PNS).4 kinds of antibody-positive autoimmune paraneoplastic limbic encephalitis(PLE)have not been reported.CASE SUMMARY PNS are distant effects of cancer on the nervous system,rather than syndromes in which cancer directly invades and metastasizes to the nerves and/or muscle tissues.If the limbic lobe system of the brain is involved,this will result in PLE.The detection of patients with PNS is challenging since tumors that cause paraneoplastic neurologic disorders are often asymptomatic,obscure,and thus easily misdiagnosed or missed.Currently,single-or double-antibody-positive paraneoplastic marginal encephalitis has been reported.However,no cases of three or more-antibody-positive cases have been reported.Here,we report a case of PLE that is anti-collapsing response-mediator protein-5,anti-neuronal nuclear antibody-type 1,anti-aminobutyric acid B receptor,and anti-glutamate deglutase positive,and address relevant literature to improve our understanding of the disease.CONCLUSION This article reports on the management of a case of PLE with four positive antibodies,a review of the literature,in order to raise awareness among clinicians.
文摘Objective: To investigate the serum VCAM-1 content in children with viral encephalitis and its correlation with nerve injury and inflammatory response. Methods: A total of 60 children with viral encephalitis who were treated in Xianyang First People's Hospital between December 2015 and January 2017 were selected as viral encephalitis group, and 50 healthy children who accepted vaccination in the hospital during the same period were selected as normal control group. The differences in serum levels of VCAM-1, nerve injury-related indexes and inflammatory factors were compared between two groups of children, and Pearson test was used to further evaluate the correlation of serum VCAM-1 content with nerve injury and inflammatory response in children with viral encephalitis. Results: Immediately after admission, serum VCAM-1 content of children with viral encephalitis was significantly higher than that of normal control group;serum nerve injury-related indexes CK-BB, MBP, β-EP and NSE contents were higher than those of normal control group;serum inflammatory factors IL-6, IL-18 and γ-IFN contents were higher than those of control group. Pearson test showed that serum VCAM-1 content in children with viral encephalitis was positively correlated with nerve injury and inflammatory response. Conclusion: Serum VCAM-1 content is high in children with viral encephalitis, and the specific content is directly correlated with the severity of nerve injury and inflammatory response.
文摘Neurological manifestations in H1N1 influenza A infection are very rare, especially in adults, and its mechanism of action is still uncertain. Here, we reported the case of a 53-year-old woman with human immunodeficiency virus infection (HIV) who had H1N1 influenza A pneumonia complicated with very rare acute necrotizing encephalitis, although the HIV was under control. With prompt identification and administration of high dosage of dexamethasone, her mental status improved from stupor to clear, with minimal right hemiparesis. Further, brain magnetic resonance image revealed great resolution of mass effect. This dramatic improvement in response to the treatment may improve our understanding of the pathophysiology between H1N1 influenza A infection and acute necrotizing encephalitis.
文摘Objective: To explore the changes of MCP-1, FKN, and related cytokines in the serum and cerebrospinal fluid (CSF) in children with epidemic encephalitis B. Methods: A total of 40 children with epidemic encephalitis B who were admitted in our hospital from June, 2014 to June, 2017 were included in the study and divided into the severe group (n=15) and general group (n=25) according to the severity group. Moreover, 20 children who were suffered from oblique inguinal hernia, perineal adhesion, and cryptorchidism were served as the control group. The serum and CSF specimens were collected 24 h after admission and during the recovery period in children with epidemic encephalitis B. The serum specimen was collected 24 h after admission in the control group, and CSF specimen was collected during the lumbar puncture. ELISA was used to detect CMP-1, FKN, IL-1β, IL-18, and TNF-α levels in the serum and CSF. CMP-1, FKN, IL-1β, IL-18, and TNF-α levels in children with epidemic encephalitis B on the day after admission and 2-3 weeks after admission and in the control group were compared. The changes of CMP-1, FKN, IL-1β, IL-18, and TNF-α in children with severe and general epidemic encephalitis B were observed. Results: CMP-1 and FKN levels in the serum and CSF in children with epidemic encephalitis B in the critical stage were significantly higher than those in the recovery stage and in the control group. The serum CMP-1 and FKN levels in children with epidemic encephalitis B during the recovery stage were not significantly different from those in the control group, while CMP-1 and FKN levels in CSF were significantly higher than those in the control group. CMP-1 and FKN levels in the serum and CSF in children with severe epidemic encephalitis B were significantly higher than those in the general group. IL-1β, TNF-α, and IL-18 levels in the serum and CSF in children with epidemic encephalitis B during the critical stage were significantly higher than those during the recovery stage and in the control group. IL-1β, TNF-α, and IL-18 levels in the serum and CSF in children with epidemic encephalitis B during the recovery stage were significantly higher than those in the control group. IL-1β, TNF-α, and IL-18 levels in the serum and CSF in children with severe epidemic encephalitis B were significantly higher than those in the general group. Conclusions: CMP-1, FKN, IL-1β, TNF-α, and IL-18 levels in the serum and CSF in children with epidemic encephalitis B are correlated with the severity degree, detection of which can contribute to estimate the clinical typing and condition change of epidemic encephalitis.
