Journal of neuroimmunology最新文献

{"title":"Clear-positive cut off determination of flow cytometric MOG-antibody assay in Korea: Alignment with international MOGAD diagnostic standards","authors":"Young Nam Kwon ,&nbsp;Woohee Ju ,&nbsp;Jae hyun Jeon ,&nbsp;Chorong Hahm ,&nbsp;Jung-Joon Sung ,&nbsp;Sung-Min Kim","doi":"10.1016/j.jneuroim.2025.578806","DOIUrl":"10.1016/j.jneuroim.2025.578806","url":null,"abstract":"<div><h3>Background</h3><div>MOG-Ab assay is a sensitive and specific biomarker that is indispensable in diagnosis of MOG antibody-associated disease (MOGAD). However, its accuracy can largely depend on a proper selection of patients also on cut-off value setting. We updated the cut-off value of flow cytometric MOG antibody assay in Korea, into low- and clear-positive, in alignment with 2023 International MOGAD Panel proposal.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 695 patients who underwent live cell-based flow cytometric MOG-Ab testing at Seoul National University Hospital from August 2023 to January 2024. Cut-off values for mean fluorescence intensity ratio (MFIr) were determined using disease controls, and diagnostic accuracy was assessed at three thresholds: Low Positive (&gt;2.61), Clear-Positive (&gt;5.66), and High Clear-Positive (&gt;10.0).</div></div><div><h3>Results</h3><div>Among 671 non-MS/NMOSD patients, 159 had core clinical demyelinating events, and 66 met 2023 international panel criteria for MOGAD. The diagnostic accuracies for low-positive, clear-positive, and high clear-positive results were as follows: sensitivity of 100 %, 59.1 %, and 33.3 %, respectively; specificity of 95.7 %, 95.9 %, and 100 %; positive predictive value (PPV) of 71.0 %, 90.7 %, and 100 %; and negative predictive value of 100 %, 95.9 %, and 93.5 %. In 159 patients with core clinical demyelinating events excluding MS and NMOSD, clear-positive threshold demonstrated a PPV of 100 %.</div></div><div><h3>Conclusion</h3><div>This study updates the cut-off values of flow cytometric MOG-Ab assay and its diagnostic accuracies in Korea in accordance with the 2023 International Panel recommendation. Our findings can contribute to improving the diagnostic accuracy of MOGAD in Korea and to strengthening the scientific validity of MOGAD research data from Korean cohort.</div></div>","PeriodicalId":16671,"journal":{"name":"Journal of neuroimmunology","volume":"410 ","pages":"Article 578806"},"PeriodicalIF":2.5,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145564367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Syringic acid suppresses inflammation by upregulation of SOCS3","authors":"Amina Khatun ,&nbsp;Surendra Patra ,&nbsp;Susovon Chowdhury ,&nbsp;Jayasree Saha ,&nbsp;Ritobrata Goswami ,&nbsp;Shrabani Pradhan ,&nbsp;Kuntal Ghosh ,&nbsp;Sudipta Chakrabarti","doi":"10.1016/j.jneuroim.2025.578813","DOIUrl":"10.1016/j.jneuroim.2025.578813","url":null,"abstract":"<div><div>Suppressor of cytokine signalling 3 (SOCS3), a protein that inhibits inflammatory molecules in microglia. A plant-derived phenolic compound, Syringic acid (SA), selectively increased SOCS3 levels in N-9 mouse microglial cells in a dose- and time-dependent manner. Similar effects were also observed in mouse primary microglia and astrocytes. In Lipopolysaccharide (LPS)-stimulated N-9 cells, SOCS3 expression decreased, but after SA treatment (LPS + SA), both mRNA and protein levels of SOCS3 increased. At the same time, pro-inflammatory mediators such as Tumor Necrosis Factor alpha (TNFα), Interleukin-1 receptor, type I (IL1R1), Interleukin-1 beta (IL1β), and Inducible Nitric Oxide Synthase (iNOS) were suppressed, along with a reduction in intracellular Reactive Oxygen Species generation (ROS) in LPS + SA-treated N-9 cells. Additionally, the expression of phospho-CREB was enhanced in LPS + SA-treated N-9 cells compared to only LPS-stimulated cells. Following the SiRNA knockdown of cAMP response element-binding protein (CREB), the upregulation of SOCS3 by syringic acid was abolished. These results confirm the role of CREB in this process. The findings suggest that SA promotes CREB activation, leading to SOCS3 expression, which may have therapeutic potential in neuroinflammatory disorders.</div></div>","PeriodicalId":16671,"journal":{"name":"Journal of neuroimmunology","volume":"410 ","pages":"Article 578813"},"PeriodicalIF":2.5,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145569186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modulation of inflammatory and regenerative responses by Galectin-3 after spinal cord injury in wild-type and Galectin-3 knockout mice","authors":"Emanuela Bezerra dos Santos Ribeiro ,&nbsp;Luiza dos Santos Heringer ,&nbsp;Bruna dos Santos Ramalho ,&nbsp;Tiago Bastos Taboada ,&nbsp;Fernanda Martins de Almeida ,&nbsp;Ana Maria Blanco Martinez","doi":"10.1016/j.jneuroim.2025.578818","DOIUrl":"10.1016/j.jneuroim.2025.578818","url":null,"abstract":"<div><div>Spinal cord injury (SCI) occurs either after a sudden trauma or through a chronic process at segmental levels of the spinal cord, leading to potentially deleterious neural consequences for the central nervous system (CNS) due to the death of neurons, oligodendrocytes, and astrocytes, as well as significant losses in motor, sensory, and autonomic functions. After SCI, an inflammatory response occurs, with cells such as macrophages and microglia being recruited. These cells are responsible for removing damaged tissue and secreting pro-inflammatory and anti-inflammatory cytokines and chemokines. Additionally, a protein called galectin-3 has been described as participating in cell activation, proliferation, and migration, acting as a mediator of inflammation in neurodegeneration. Thus, different populations of inflammatory cells in the injured nervous parenchyma can be characterized. In this study, we used a spinal cord contusion-compression model in wild-type C57Bl/6 mice (WT) and galectin-3 knockout mice (GAL3−/−) to histologically characterize the lesion, focusing on astrocyte, macrophage, and microglial populations. Our results showed a significant reduction in lesion propagation in GAL3−/− animals compared to WT animals. Moreover, GAL3−/− animals exhibited reduced astrogliosis compared to WT animals. Immunohistochemistry revealed that GAL3−/− animals had a larger area marked for the anti-inflammatory marker Arginase-1 and a smaller area marked for the pro-inflammatory marker iNOS compared to WT animals. We conclude that galectin-3 plays a critical role in the inflammatory process following spinal cord injury, and its absence may contribute to reduced lesion progression, decreased astrogliosis, and the promotion of an inflammatory response with a more anti-inflammatory profile.</div></div><div><h3>Significance statement</h3><div>This study highlights galectin-3 as a central mediator of the inflammatory response after spinal cord injury, demonstrating that galectin-3 deficiency limits lesion progression, attenuates astrogliosis, and promotes an anti-inflammatory profile. Thus, galectin-3 may represent a promising potential therapeutic target for clinical applications in neurodegenerative diseases.</div></div>","PeriodicalId":16671,"journal":{"name":"Journal of neuroimmunology","volume":"410 ","pages":"Article 578818"},"PeriodicalIF":2.5,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145587881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinally-extensive transverse myelitis in the setting of recent Mycoplasma infection: Case series","authors":"Kyra Curtis ,&nbsp;Erin Hendry ,&nbsp;Zachary Christensen ,&nbsp;Bryce Aidukaitis ,&nbsp;Anjili Vara ,&nbsp;Geoffrey A. Weinberg ,&nbsp;Jennifer Nayak ,&nbsp;Bo Hoon Lee ,&nbsp;Robert Thompson Stone","doi":"10.1016/j.jneuroim.2025.578785","DOIUrl":"10.1016/j.jneuroim.2025.578785","url":null,"abstract":"<div><div>Longitudinally-extensive transverse myelitis (LETM) is a rare but serious inflammatory myelopathy, often presenting with broad neurological symptoms with numerous possible etiologies that pose diagnostic and therapeutic challenges. Here we report three pediatric cases of aggressive LETM with recent <em>Mycoplasma pneumoniae (M. pneumoniae)</em> infection. All patients presented with rapid-onset lower extremity weakness and varying degrees of sensory changes and autonomic dysfunction. MRI confirmed extensive and expansile spinal cord lesions in each case. While <em>M. pneumoniae</em> throat nucleic acid amplification test (NAAT) was positive in all cases, CSF PCR was negative in two (and not performed in the third), raising the question of causality. Treatment regimens and functional outcomes varied, where one patient experienced persistent paraplegia. These cases highlight the potential association between <em>M. pneumoniae</em> and LETM, the diagnostic challenges posed by overlapping infectious and autoimmune features, and the need for early, aggressive treatment. Further research is needed to clarify the pathogenesis of this condition in order to optimize treatment and patient outcomes.</div></div>","PeriodicalId":16671,"journal":{"name":"Journal of neuroimmunology","volume":"410 ","pages":"Article 578785"},"PeriodicalIF":2.5,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145419760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acupuncture mitigates sciatic neuropathic pain in lumbar disc herniation via inhibiting spinal CXCL12/CXCR4-driven glial activation and neuroinflammation","authors":"Fudong Shi ,&nbsp;zhiyi Wu ,&nbsp;Jinyan Yin ,&nbsp;Yuzhang Liu ,&nbsp;Zuoxu Li ,&nbsp;Shimin Zhang","doi":"10.1016/j.jneuroim.2025.578797","DOIUrl":"10.1016/j.jneuroim.2025.578797","url":null,"abstract":"<div><div>Lumbar disc herniation (LDH) is a prevalent degenerative spinal disorder causing chronic low back pain and sciatica through persistent neuroinflammation and central sensitization. Increasing evidence implicates the CXCL12/CXCR4 signaling axis in these processes, yet its modulation by acupuncture remains unclear. To explore this mechanism, a rat model of LDH was established by autologous nucleus pulposus implantation adjacent to the L5 dorsal root ganglion, and behavioral hypersensitivity was assessed using von Frey and plantar tests. LDH induced marked mechanical and thermal hyperalgesia accompanied by upregulation of CXCL12 and CXCR4 in the spinal dorsal horn. CXCL12 localized mainly to neurons and microglia, while CXCR4 was expressed in neurons, astrocytes, and microglia. Pharmacological blockade of CXCR4 with AMD3100 alleviated hypersensitivity and reduced neuronal and glial activation. Acupuncture similarly increased withdrawal thresholds, inhibited c-Fos, GFAP, and Iba-1 expression, and suppressed TNF-α, IL-1β, and IL-6 levels, whereas exogenous CXCL12 reversed these effects. Acupuncture also inhibited ERK1/2 and NF-κB phosphorylation, and selective inhibition of these pathways with PD98059 or PDTC reproduced its analgesic effects. These findings identify the CXCL12/CXCR4–ERK/NF-κB axis as a critical mediator of LDH-induced neuroinflammation and demonstrate that acupuncture mitigates neuropathic pain by suppressing this signaling pathway and glial activation.</div></div>","PeriodicalId":16671,"journal":{"name":"Journal of neuroimmunology","volume":"410 ","pages":"Article 578797"},"PeriodicalIF":2.5,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145504620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of intravenous efgartigimod for chronic inflammatory demyelinating polyneuropathy: A case series real-world study","authors":"Ruojie He ,&nbsp;Zhanhua Zhong ,&nbsp;Huiyu Feng,&nbsp;Xiaoli Yao","doi":"10.1016/j.jneuroim.2025.578796","DOIUrl":"10.1016/j.jneuroim.2025.578796","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the treatment effecitiveness and safety of Chinese patients with chronic inflammatory demyelinating polyneuropathy (CIDP) treated with intravenous efgartigimod in this real-world study.</div></div><div><h3>Methods</h3><div>This study analyzed data retrospectively from 13 patients with CIDP treated with efgartigimod at the Department of Neurology, First Affiliated Hospital of Sun Yat-Sen University from December 2023 to September 2024. Clinical assessment scales included the Inflammatory Neuropathy Cause and Treatment (INCAT) score and the Medical Research Council (MRC) sum score were utilized to evalutate effecitiveness before and after efgartigimod treatments. Adverse events werer monitored to assess the safety of efgartigimod treatments.</div></div><div><h3>Results</h3><div>The mean onset age of 13 patients was 38.3 years, and the mean duration from symptom onset to diagnosis was 13.1 months. About 46 % patients in our study were typical CIDP subtype. About 77 % patients experienced relapses before efgartigimod treatments. Clinical improvements were observed in 12 patients (92.3 %) with at least 1-point decrease on INCAT scores at 12 weeks follow-up, indicating efgartigimod treatment effectiveness. Eleven patients (84.6 %) achieved clinical improvements at 24 weeks follow-up. At last follow-up, five patients (38.5 %) had discontinued immunotherapy. Adverse events monitoring revealed that only one patient had pruritus which alleviated spontaneously.</div></div><div><h3>Conclusion</h3><div>This case series real-world study support the efficacy and safety of efgartigimod treatment in CIDP patients, benefit on partially reducing the usage of glucocorticoids and immunosuppressants. It was well tolerated across age groups. Larger prospective studies are needed to refine dosing and establish guidelines for CIDP management.</div></div>","PeriodicalId":16671,"journal":{"name":"Journal of neuroimmunology","volume":"410 ","pages":"Article 578796"},"PeriodicalIF":2.5,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145564293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IL-17 and IL-22 in Guillain-Barré syndrome: Untangling disease-specific signals from confounding factors","authors":"Christian Messina","doi":"10.1016/j.jneuroim.2025.578820","DOIUrl":"10.1016/j.jneuroim.2025.578820","url":null,"abstract":"","PeriodicalId":16671,"journal":{"name":"Journal of neuroimmunology","volume":"410 ","pages":"Article 578820"},"PeriodicalIF":2.5,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145615381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Iatrogenic NORSE: Immune checkpoint inhibitor-related anti-GFAP autoimmune astrocytopathy","authors":"Chiara Marotta ,&nbsp;Elisabetta Rolla ,&nbsp;Martina Fabris ,&nbsp;Rossana Domenis ,&nbsp;Jérôme Honnorat ,&nbsp;Donatella Iacono ,&nbsp;Giuseppe Aprile ,&nbsp;Mariarosaria Valente ,&nbsp;Alberto Vogrig","doi":"10.1016/j.jneuroim.2025.578805","DOIUrl":"10.1016/j.jneuroim.2025.578805","url":null,"abstract":"<div><div>Immune checkpoint inhibitors (ICIs) have radically improved cancer therapy but are associated with a spectrum of immune-related adverse events (irAEs), including infrequent (1–3 %) neurological complications. Pembrolizumab, an anti-PD-1 monoclonal antibody, enhances antitumor immunity but may disrupt self-tolerance, leading to autoimmune phenomena. This case report describes a patient with triple metachronous malignancies (cerebral hemangioblastoma, clear cell renal carcinoma, and non-small cell lung cancer, NSCLC), who developed glial fibrillary acidic protein (GFAP)-antibody-associated autoimmune encephalitis following pembrolizumab therapy initiated as NSCLC treatment. The clinical course was marked by subacute neurocognitive decline followed by new-onset refractory status epilepticus (NORSE). Diagnostic workup revealed GFAP antibodies in cerebrospinal fluid as well as serum, with no evidence of tumor progression or infectious causes. Although GFAP astrocytopathy has been rarely linked to ICIs, this appears to be the first report manifesting with NORSE. The temporal association with cancer immunotherapy, the presence of GFAP autoantibodies, and a positive steroid response collectively suggest that ICI-induced immune dysregulation is the primary disease mechanism. This report, in conjunction with other isolated descriptions form the literature with other antibody specificities, paves the way to a new spectrum of etiologies for NORSE, namely iatrogenic causes related to cancer immunotherapy.</div></div>","PeriodicalId":16671,"journal":{"name":"Journal of neuroimmunology","volume":"410 ","pages":"Article 578805"},"PeriodicalIF":2.5,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145513088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics and prognosis of PCA-1 (anti-Yo) autoimmunity and the utility of the Brief Ataxia Rating Scale in a seropositive cerebellar ataxia cohort","authors":"Sophia Cerroni ,&nbsp;Yoji Hoshina ,&nbsp;Trevor Glenn ,&nbsp;Nupur Goel ,&nbsp;Bruna Leles Vieira de Souza ,&nbsp;Joao Vitor Mahler ,&nbsp;Mattia Wruble ,&nbsp;Giovanna S. Manzano","doi":"10.1016/j.jneuroim.2025.578812","DOIUrl":"10.1016/j.jneuroim.2025.578812","url":null,"abstract":"<div><h3>Background</h3><div>Autoimmune cerebellar ataxia (ACA), whether paraneoplastic, classically associated with PCA-1 autoimmunity, or non-paraneoplastic, causes substantial morbidity. Antibodies inform clinical decisions given prognostic differences. The modified Rankin Scale (mRS) and Clinical Assessment Scale in Autoimmune Encephalitis (CASE) underrepresent cerebellar change. We aimed to characterize seropositive ACA, compare PCA-1 with other seropositive cases, identify predictors of poor function, and compare outcome measures.</div></div><div><h3>Methods</h3><div>We performed a retrospective cohort study of adults with seropositive ACA at Massachusetts General Brigham (2004–2025). We compared anti-PCA-1 positive with other seropositive cohorts. Time to wheelchair dependence was estimated by Kaplan-Meier and compared by log-rank. Univariable Cox models identified predictors. Outcomes were assessed with mRS, CASE, and Brief Ataxia Rating Scale (BARS).</div></div><div><h3>Results</h3><div>Nineteen patients (median age 66.3 years; 68.4 % female) were included. Eleven (57.9 %) were anti-PCA-1 positive and all of them were paraneoplastic. Tubo-ovarian serous carcinoma was most common (63.6 %). The anti-PCA-1 positive group was more often female (90.9 % vs. 37.5 % <em>p</em> = 0.04), had worse BARS at last follow up (20 vs. 9.5 <em>p</em> &lt; 0.01), and had higher wheelchair dependence (100 % vs. 37.5 % p &lt; 0.01). Acute onset (&lt; 2 weeks) and PCA-1 positivity were associated with wheelchair dependence. BARS monitored symptoms more precisely than mRS or CASE.</div></div><div><h3>Conclusion</h3><div>In this seropositive ACA cohort, PCA-1 autoimmunity was associated with wheelchair dependence despite immunotherapy and cancer treatment. Acute onset may predict severe decline. A cerebellar symptom specific measure such as BARS may assess clinical change better than mRS or CASE for monitoring ACA.</div></div>","PeriodicalId":16671,"journal":{"name":"Journal of neuroimmunology","volume":"410 ","pages":"Article 578812"},"PeriodicalIF":2.5,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145569196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autoimmune encephalitis following bevacizumab therapy in ovarian carcinoma: A case report and review","authors":"Bengül Fatma Gölge ,&nbsp;Cansu Sarıkaya ,&nbsp;Canan Aykut Bingöl ,&nbsp;Berrin Aktekin ,&nbsp;Rana Karabudak ,&nbsp;Gazanfer Ekinci ,&nbsp;Serkan Çelik","doi":"10.1016/j.jneuroim.2025.578804","DOIUrl":"10.1016/j.jneuroim.2025.578804","url":null,"abstract":"<div><h3>Background</h3><div>Autoimmune encephalitis (AE) is increasingly recognized in clinical practice, yet drug-related encephalitic syndromes remain a diagnostic challenge. Immune checkpoint inhibitors (ICIs) are well-established triggers, whereas vascular endothelial growth factor (VEGF) inhibitors such as Bevacizumab are only rarely implicated, with evidence confined to case reports. Awareness of this association is essential as targeted therapies gain prominence in metastatic cancer care.</div></div><div><h3>Case presentation</h3><div>We describe a 58-year-old woman with hypothyroidism and advanced ovarian carcinoma, who had previously undergone surgery and adjuvant chemotherapy in 2022 and metastasectomy for bowel involvement in 2024. She was in remission under Bevacizumab–chemotherapy combination therapy when, following reoperation for peritoneal adhesions in February 2025, she developed two episodes of transient loss of consciousness. During the attacks, fluctuating blood pressure, visual phenomena, and transient foreign-language speech were observed. MRI initially revealed left occipital leptomeningeal enhancement, and EEG showed lateralized epileptiform discharges and non-convulsive status epilepticus was considered. Although initial events were interpreted as seizure-related changes, follow-up imaging on day 15 revealed persistent abnormalities with new cortical and thalamic FLAIR hyperintensities. Neurological examination demonstrated drowsy consciousness, right homonymous hemianopia, motor aphasia, dystonic posturing of the right hand, and sensory integration deficits. Cerebrospinal fluid cytology, paraneoplastic, and autoimmune antibody panels were negative. Pulse intravenous methylprednisolone was initiated, leading to significant clinical improvement and partial radiologic regression, although word-finding difficulties persisted at last follow-up.</div></div><div><h3>Conclusion</h3><div>This case illustrates an atypical, steroid-responsive encephalitic syndrome temporally associated with Bevacizumab. Unlike the well-characterized bilateral parieto-occipital patterns of PRES, our patient demonstrated unilateral leptomeningeal and cortical–thalamic involvement. The case underscores the importance of repeated neuroimaging, systematic exclusion of alternative etiologies, and timely immunotherapy in suspected drug-related encephalitis. Accumulation of further cases will be essential to clarify incidence, mechanisms, and optimal management of Bevacizumab-associated encephalitis.</div></div>","PeriodicalId":16671,"journal":{"name":"Journal of neuroimmunology","volume":"410 ","pages":"Article 578804"},"PeriodicalIF":2.5,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145517667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}