Editorial Comment: Two-Year-Old Boy With Recurrent Seizures, Abnormal Movements, and Central Hypoventilation

In this issue, Drs Cohen and Wong-Kisiel describe an illustrative case of severe N-methyl-D-aspartate receptor (NMDAR) encephalitis with a protracted clinical course. They describe a positive response to aggressive treatment following suboptimal response to first-line immunosuppressive therapies. The case illustrates some important aspects of the early diagnosis and treatment of NMDAR antibody–mediated encephalitis that can be challenging in young children. In these cases, important clues to the diagnosis could be missed or attributed to other possible etiologies. The discussion thoroughly summarizes the current knowledge and limitations regarding the lack of standardized treatment protocols and the protracted course of some of these patients.
Source: Seminars in Pediatric Neurology - Category: Neurology Authors: Source Type: research

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Publication date: Available online 22 February 2020Source: Ticks and Tick-borne DiseasesAuthor(s): Jeong Rae Yoo, Jung Hwan Oh, Keun Hwa Lee, Sung Wook SongAbstractNo human cases of tick-borne encephalitis (TBE) have been reported in South Korea. We tested for TBE virus (TBEV)-IgM and -IgG in serum samples from healthy farmers during 2015-2018 using ELISA kits. Seroprevalence study revealed a 1.9% prevalence rate of TBEV. A neutralizing test for TBEV-specific antibodies was not performed.
Source: Ticks and Tick borne Diseases - Category: Zoology Source Type: research
Publication date: Available online 22 February 2020Source: Multiple Sclerosis and Related DisordersAuthor(s): Chi Hou, Wenlin Wu, Yang Tian, Yani Zhang, Haixia Zhu, Yiru Zeng, Bingwei Peng, Kelu Zheng, Xiaojing Li, Wenxiong ChenAbstractObjective: To analyze the clinical features in children with anti-NMDAR encephalitis combined with myelin oligodendrocyte glycoprotein antibody (MOG ab).Methods: Clinical data of 7 children with anti-NMDAR encephalitis combined with MOG ab(+) were collected in Guangzhou Women and Children's Medical Center from January, 2016 to June, 2019. Children with NMDAR ab(+)/MOG ab(-) and MOG ab(+)/NMD...
Source: Multiple Sclerosis and Related Disorders - Category: Neurology Source Type: research
ConclusionTesting for MOG Abs should be considered in children with isolated and unexplained seizures, and in adults with suspected encephalitis and/or seizures. In these cases, MOG Abs detection is highly relevant for patients’ clinical management.
Source: Multiple Sclerosis and Related Disorders - Category: Neurology Source Type: research
In this study, all tick-borne encephalitis virus (TBEV) E gene sequences available in GenBank as of June 2019 with known date of isolation (n = 551) were analyzed. Simulation studies showed that a sample bias could significantly affect earlier studies, because small TBEV datasets (n = 50) produced non-overlapping intervals for evolutionary rate estimates. An apparent lack of a temporal signal in TBEV, in general, was found, precluding molecular clock analysis of all TBEV subtypes in one dataset. Within all subtypes and most of the smaller groups in these subtypes, there was evidence of many medium- and long-distance virus ...
Source: Viruses - Category: Virology Authors: Tags: Article Source Type: research
Dr Oliver Flower Turning a Zebra into a Horse A deep dive into a much more common frightening entity than you may think. Turning a zebra into a horse with David Carr
Source: Life in the Fast Lane - Category: Emergency Medicine Authors: Tags: Clinical Crit Care challenge David Carr diagnosis Encephalitis zebra Source Type: blogs
Anti-N-methyl-d-aspartate receptor (NMDA) encephalitis is characterized by a wide spectrum of neuropsychiatric symptoms. Approximately one quarter of the patients with anti-NMDA encephalitis have been reported to have an underlying neoplasm, such as ovarian teratomas, small cell lung carcinoma, uterine adenocarcinoma, prostate adenocarcinoma, Hodgkin lymphoma, neuroblastoma, and pancreatic neuroendocrine tumor [1]. To our knowledge, however, NMDA encephalitis associated with pheochromocytoma has never been reported.
Source: Parkinsonism and Related Disorders - Category: Neurology Authors: Tags: Correspondence Source Type: research
We report the case of a 28-year-old man diagnosed with a mediastinal germ cell tumor 9 years after presenting with anti-Hu-positive limbic encephalitis.
Source: Neurology Neuroimmunology and Neuroinflammation - Category: Neurology Authors: Tags: Autoimmune diseases, Paraneoplastic syndrome Clinical/Scientific Notes Source Type: research
Torphy DE, Ray CG, McAlister R, Du JN. Herpes simplex virus infection in infants: A spectrum of disease. J Pediatr 1970;76:405-8 and Charnock EL, Cramblett HG. 5-Iodo-2 ′-deoxyuridine in neonatal herpesvirus hominis encephalitis. J Pediatr 1970;76:459-63.
Source: The Journal of Pediatrics - Category: Pediatrics Authors: Source Type: research
Authors: Dietrich DE, Bode L, Spannhuth CW, Hecker H, Ludwig H, Emrich HM Abstract BACKGROUND: Whether Borna disease virus (BDV-1) is a human pathogen remained controversial until recent encephalitis cases showed BDV-1 infection could even be deadly. This called to mind previous evidence for an infectious contribution of BDV-1 to mental disorders. Pilot open trials suggested that BDV-1 infected depressed patients benefitted from antiviral therapy with a licensed drug (amantadine) which also tested sensitive in vitro. Here, we designed a double-blind placebo-controlled randomized clinical trial (RCT) which cross-lin...
Source: BMC Pharmacology and Toxicology - Category: Drugs & Pharmacology Tags: BMC Pharmacol Toxicol Source Type: research
Limbic encephalitis (LE) with antibodies against leucine-rich glioma inactivated protein 1 (LGI1) is an autoimmune disease with variable clinical features, including seizures, cognitive disorders, psychiatric disturbances, and hyponatremia. The majority of these patients present faciobrachial dystonic seizures (FBDS), which are regarded as a characteristic symptom. A few cases have reported pilomotor seizures as the main manifestation of anti-LGI1 encephalitis. Here, we described a Chinese woman with frequent pilomotor seizures who was finally diagnosed as having anti-LGI1 encephalitis. Our report emphasizes the possible s...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
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