• Title/Summary/Keyword: encephalitis

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A Case of Paraneoplastic Limbic Encephalitis Associated with Primary Adenocarcinoma of Lung (비소세포 폐암과 동반된 부수종양성 변연계뇌염 1예)

  • Shin, Hyun Jong;Kim, Hyun Soo;Lim, Keum Nam;Noh, U Seok;Choi, Jung Hye;Kim, In Soon;Lee, Young Yeul;Park, Byeong Bae;Park, Dong Woo
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.4
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    • pp.382-386
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    • 2007
  • Paraneoplastic limbic encephalitis is a rare disorder that is characterized by personality changes, irritability, depression, seizures, memory loss and dementia, and is commonly associated with small cell lung cancer. The cause is unknown but it is believed to be an autoimmune disorder that develops secondary to a carcinomatous process. We report a patient with the clinical feature consistent with limbic encephalitis. A 64-year-old women developed disorientation, memory loss and general weakness. She was diagnosed with NSCLC (adenocarcinoma) with a brain metastasis 1 year earlier and was treated with radiation and chemotherapy. Although the lung mass and brain metastatic lesions had improved, the brain T2-weighted MRI showed high signal intensity in the right temporal region. This lesion consisted of with limbic encephalitis and was negative to the other viral and immune markers. The patient's symptoms did not improve after steroid treatment. Our case demonstrated that a NSCLC (adenocarcinoma) also can be associated with paraneoplastic limbic encephalitis.

A Case Report of Anti-NMDA Receptor Encephalitis with Ovarian Teratoma Improved by Korean Medicine (난소기형종을 동반한 항 NMDA 수용체 뇌염 환자 1례에 대한 한방치료 증례 보고)

  • Irang Nam;Min-hwa Kim;Mariah Kim;Ki-beom Ku;Se-yeon Lee;So-yeon Kim;So-jung Park;Jun-yong Choi;Chang-woo Han;Jin-woo Hong;Ji-won Kang;In Lee
    • The Journal of Internal Korean Medicine
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    • v.44 no.6
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    • pp.1337-1345
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    • 2023
  • Objectives: This study reports on the improvement of anti-N-methyl-D-aspartate (NMDA) receptor encephalitis with ovarian teratoma after Korean medicine treatment. Methods: A patient was treated with Korean medicine treatments, such as acupuncture and herbal medications (Gami-ondam-tang and Samulanshin-tang-gamibang). The patient's improvement was evaluated using manual muscle testing (MMT), the Mini-Mental State Exam-Korea (MMSE-K), the modified Barthel index (MBI), and the Clinical Assessment Scale in Autoimmune Encephalitis (CASE). Results: After using Korean medicine treatments, the patient's MMT, MMSE-K, and MBI scores increased, and the CASE score decreased. Conclusion: This case suggests that Korean medicine can be effective in treating the symptoms of anti-NMDA receptor encephalitis.

Detection of Herpes Simplex Virus, Varicella-Zoster Virus and Human Herpes Virus-6 by PCR in Cerebrospinal Fluid from Hospitalized Adult Patients with Aseptic Meningitis or Encephalitis (무균성 뇌막염과 뇌염으로 입원한 성인 환자 뇌척수액에서 중합효소 연쇄반응에 의한 HSV, VZV, HHV-6의 검출)

  • Park, Hae-Kyung;Woo, So-Youn;Kim, Hyun-Jin;Chong, Young-Hae
    • The Journal of Korean Society of Virology
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    • v.30 no.3
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    • pp.171-178
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    • 2000
  • Herpes simplex virus, Varicella zoster virus and Human herpes virus-6 caused central nervous system infections and latent infections but there is no data of the 3 viruses being tested from the same cerebrospinal fluid samples with aseptic meningitis or encephalitis in adults patients. These viruses produced similar neurologic symptoms but difficulties existed in differentiating of etiologic agents and therefore the viruses needed to be detected in the early state. Herpes simplex virus encephalitis (HSVE) in adults, if not treated promptly was fatal. If treated with antiviral drugs in the early phase of encephalitis, neurologic sequales decreased by 65%. Recently, a PCR method for detection of HSVE with CSF was developed. VZV primary and secondary infections caused neurologic symptoms of encephalitis or meningitis. The second frequency of adult encephalitis that caused VZV were reported. HHV-6 caused CNS latent infection that was studied with normal adults brains. But there is no data of HSV, VZV and HHV-6 for aseptic meningitis and encephalitis of Korean adults through etiologic study. We cultured CSFs on HEp-2 cells and simultaneously tested for HSV PCR, VZV nested PCR and HHV-6 PCR with 8 specific primers. The PCR results of CSF from meningitis Korean adults were 13/19 (68.4%) for HSV, 10/19 (52.6%) for VZV and 12/19 (63.2%) for HHV-67/19 (36.8%) cases were triple infected HSV PCR, VZV PCR and HHV-6 PCR positive; 3/19 (15.8%) cases were dual infected HSV PCR and HHV-6 PCR positive; 1119 (0.5%) cases was VZV PCR positive. Strong viral DNA amplification of CSF means a causative virus may be present in aseptic meningitis or encephalitis patients and may cause clinical neurologic symptoms. HSV and HHV-6 viruses detection rate were higher than VZV by PCR with CSFs.

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A case of encephalitis in a juvenile rheumatoid arthritis patient treated with etanercept (소아기 류마티스모양 관절염 환자에서 etanercept 사용 후 발생한 뇌염 1예)

  • Kwon, Ah Reum;Park, Eun Jung;Kim, Ki Hwan;Kim, Dong Soo
    • Clinical and Experimental Pediatrics
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    • v.53 no.2
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    • pp.262-266
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    • 2010
  • Tumor necrosis $factor-{\alpha}$ ($TNF-{\alpha}$) is a major proinflammatory cytokine involved in the pathophysiology of juvenile rheumatoid arthritis. Etanercept is an effective inhibitor of $TNF-{\alpha}$ and has shown a beneficial effect in patients with JRA. However, the most important cause of concern related to etanercept administration is infection. We report a case of encephalitis in a JRA patient receiving long-term treatment with etanercept. The patient was a 4-year-old boy with refractory JRA, and he received etanercept subcutaneously at a dose of $0.4\;mg\;kg^{-1}\;day^{-1}$ twice a week for 14 months, along with non-steroidal anti-inflammatory drugs, methotrexate, oral steroids, and sulfasalazine. The patient presented with sudden fever, headache, vomiting, a generalized tonic seizure, and changes in mental status. We suspected a central nervous system infection, and simultaneously administered antibiotics, an antiviral agent, and steroids. After 2 days of hospitalization, his mental function returned to normal, and he showed no further seizure-like movements. Brain magnetic resonance imaging scan of the patient showed a multifocal cortical lesion on both sides of the temporoparietooccipital lobe, which indicated encephalitis. Although we were unable to identify the causative organism of encephalitis, we think that the encephalitis may be attributed to infection, and the use of etanercept may have increased the risk of severe infection. Therefore, etanercept was discontinued and the patient recovered shortly after. To the best of our knowledge, this is the first case of encephalitis in a juvenile rheumatoid arthritis patient treated with etanercept.

The Clinical Usefulness of Tc-99m ECD Brain SPECT in Acute Measles Encephalitis (홍역 후 발생된 급성 뇌염 진단시 Tc-99m ECD 뇌혈류 SPECT의 임상적 유용성)

  • Lim, Seok-Tae;Sohn, Myung-Hee
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.4
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    • pp.229-234
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    • 2003
  • Purpose: Since the prognosis of measles encephalitis is poor, early diagnosis and proper management are very important to improve clinical outcomes. We compared Tc-99m ECD brain SPECT (SPECT) with MR imaging (MRI) for the detection of acute measles encephalitis. Materials and Methods: Eleven patients(M : F=4 : 7, age range 18 months-14 yrs) with acute measles encephalitis were enrolled in this studies. All of them underwent both MRI and SPECT. The results of SPECT were scored from 0 (normal) to 3 (most severe defect) according to perfusion state. We compared two image modalities for the detection of brain abnormality in acute measles encephalitis. Results: Seven of 11 patients (63.6%) revealed high signal intensity in the white matter on T2WI of MRI, on the other hand all patients (100%) showed hypoperfusion on SPECT. Severe perfusion deficits above score 2 were located with decreasing frequencies in the frontal lobe (81.8%), temporal lobe (72.7%), occipital lobe (27.3%), basal ganglia (27.3%), and parietal lobe (9.1%). Conclusion: We conclude that SPECT is more useful than MRI for the detection of brain involvement in patients with acute measles encephalitis.

Histopathological features and viral genome detection in caprine arthritis encephalitis virus infected dairy goats in Korea

  • Son, Gain;Cho, Eun-Sang;Shin, Hyun-Jin;Son, Hwa-Young
    • Korean Journal of Veterinary Service
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    • v.40 no.3
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    • pp.161-168
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    • 2017
  • Caprine arthritis encephalitis (CAE) virus is a causative agent of caprine arthritis-encephalitis. In our previous study we reported a prevalence of CAE. In this study, we described the further detailed pathological features of CAE and examined the detection of virus by in situ hybridization (ISH). Histopathologically, interstitial pneumonia and bronchopneumonia in lung, focal inflammation in mammary glands, perivascular cuffing in brain, arthritis, and focal necrosis, mild steatosis, inflammatory cell infiltration of liver were noted. CAEV proviral-DNA was identified by nested polymerase chain reaction (PCR) in blood cells, brain, synovial fluid, and lymph node. Confirmation by nested PCR involved amplification of a 296 bp ($1^{st}$ PCR) and 185 bp ($2^{nd}$ PCR) fragments corresponding to a conserved region on the gag gene of CAEV. Positive ISH signals were detected in the brain and liver. In conclusion, significant histopathological findings included parenchymal infection in various organs, including the lung, liver, brain, joint, and mammary gland were noted in the CAEV infected dairy goat. ISH can help confirm the diagnosis of CAE in formalin-fixed samples.

Leptomeningeal Enhancement without Thalamic Involvement as an Initial Manifestation of Japanese Encephalitis: A Case Report (시상 침범 없는 연수막 조영증강을 보인 일본뇌염: 증례 보고)

  • Sang Hwa Woo;Ho-Joon Lee;Yeonah Kang
    • Journal of the Korean Society of Radiology
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    • v.82 no.2
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    • pp.469-474
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    • 2021
  • Japanese encephalitis (JE) is a common infection caused by the Japanese encephalitis virus in Southeast Asia, which is transmitted to humans through Culex mosquitoes. Magnetic resonance imaging (MRI) is used to diagnose JE, which is often characterized by the presence of bilateral symmetric thalamic involvement. Here, we report a rare case of JE characterized by leptomeningeal enhancement without thalamic involvement. This leptomeningeal enhancement disappeared with the treatment; however, new non-specific multifocal and bilateral high signal intensities in the cerebral white matter were found on follow-up MRI.

A case of paraneoplastic limbic encephalitis due to ovarian mature teratoma (성숙 난소기형종에 동반된 부신생물 변연계뇌염 1례)

  • Kim, Seong-Heon;Kim, Hye-Young;Im, Young-Tak;Nam, Sang-Ook;Kim, Young-Mi
    • Clinical and Experimental Pediatrics
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    • v.53 no.4
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    • pp.603-606
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    • 2010
  • Paraneoplastic limbic encephalitis, a remote effect of cancer without nervous system metastasis, is rare, especially in childhood. Here, we report a case of paraneoplastic limbic encephalitis associated with an ovarian mature teratoma in an adolescent girl. The 15-year-old girl developed neuropsychiatric symptoms, memory loss, seizures, and unconsciousness. Cerebrospinal fluid analysis and brain magnetic resonance imaging (MRI) findings were normal, while single photon emission computed tomography imaging showed hypoperfusion in both temporal lobes. Ultrasound and MRI of the abdomen revealed a left ovarian cystic mass. The patient experienced a significant recovery of cognitive function after surgical resection of the tumor, which was pathologically identified as a mature ovarian teratoma, and treatment with intravenous immunoglobulin.

Effects of Garlic Extract for Protecting the Infection of Influenza Virus (감기바이러스(인플루엔자) 감염에 대한 마늘의 방어효과)

  • 김건희;영정승차;박무현;하상도
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.29 no.1
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    • pp.128-133
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    • 2000
  • This study was designed to verify the efficacy of garlic extracts for protecting the infecton of influenza and Japanese B encephalitis virus. Influenza virus (AO/PR8 strain) and Japanese B encephalitis virus (JaGAr O1 strain) were used to attack mouse through nasal route and each vaccines were injected subcutaneously. 0.002 and 0.2 mL/day of garlic extracts were orally administered to mice. The blood and serum samples were taken from the mice to measure LD50, Defense Index (DI), virus-neutralizing antibody for comparing virus influence inhibiting activities. Defense indices of the male and female mice were not significantly different at every experiment. Vaccination effectively inhibited the influence of influenza virus and 0.002 mL/day garlic extract (0.55$\pm$0.05) resulted in significantly higher DI than the control (0$\pm$0.05) (p<0.05). Although 0.002 mL/day garlic extract (0.55$\pm$0.05) resulted in significantly lower DI than the vaccination (1.10$\pm$0.05), 0.2 mL/day garlic extract (2.05$\pm$0.05) resulted in 10 times higher DI than the vaccination (1.10$\pm$0.05). Garlic extract did not affect DI in Japanese B encephalitis virus influence of the vaccinated mouse, but significantly reduced DI of the non-vaccinated mouse (p<0.05). Garlic extracts did not affect the production of the neutralizing antibody against influenza by vaccination. However, neutralizing antibody production of Japanese B encephalitis was accelerated by vaccination. Consequently, the current study proved the efficacy of garlic on inhibition of influenza virus. Finally, it is very hard to show the higher preventing effect on flu through ingestion of garlic as a food than vaccination.

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The Case of Successful Recovery From Severe Encephalitis in a COVID-19 Pediatric Patient in Korea (국내 소아에서 심한 COVID-19 뇌염에서 성공적으로 회복된 1례)

  • EunJeong Kim;So Hyun Ki;Hye Na Jung;Yoonsun Yoon;BaikLin Eun
    • Pediatric Infection and Vaccine
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    • v.30 no.3
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    • pp.180-187
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    • 2023
  • In Korea, >90% of children and adolescents aged <19 years have been infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) since 2020. Among confirmed cases of pediatric coronavirus disease 2019 (COVID-19), 40-60% of patients developed neurologic symptoms such as seizures, headache, and encephalitis. Herein, we report the case of a 3-year-old female patient with SARS-CoV-2 infection who presented with seizures and altered consciousness and was diagnosed with COVID-19 encephalitis. The patient recovered after treatment with intravenous immunoglobulin, high-dose steroids, anti-seizure drugs, and an anti-viral agent. She was discharged after regaining the ability to speak words and walk alone on hospital day 39. Complete recovery was observed at the 1-year follow-up. The findings in this case suggest that early detection and active intervention is associated with better outcomes in patients with COVID-19 encephalitis.