Encephalitis (Seoul, Korea)最新文献

{"title":"Clinicoradiologic profile of neuromyelitis optica spectrum disorder in a Kashmiri cohort: a prospective observational cohort study.","authors":"Toufeeq Ahmad Mir, Tanveer Hassan, Sheikh Hilal Ahmad, Atif Rasool Kawoosa, Bashir Ahmad Sanaie","doi":"10.47936/encephalitis.2025.00164","DOIUrl":"10.47936/encephalitis.2025.00164","url":null,"abstract":"<p><strong>Purpose: </strong>Neuromyelitis optica spectrum disorder (NMOSD) is a rare disease that is often misdiagnosed and that can have ethnic variations. No prior study of this condition in a Kashmiri cohort has been reported, which motivated this study.</p><p><strong>Methods: </strong>This prospective, observational cohort study included 32 patients. NMOSD was diagnosed according to the International Panel for NMO Diagnosis criteria based on serology, magnetic resonance imaging (MRI), cerebrospinal fluid (CSF), and visual evoked potential (VEP) findings.</p><p><strong>Results: </strong>Among central nervous system demyelinating diseases, NMOSD constituted 20.3% of cases, with a frequency second only to multiple sclerosis. Mean age at presentation was 39 years with 78% of patients being females.90.6% were positive for aquaporin 4 (AQP4) autoantibodies. Optic neuritis (ON) was seen in relatively young patients, with a mean age of presentation of 24.7 years. Presenting syndromes included transverse myelitis (TM; 46.9%), ON (21.9%), combined ON + TM (25.0%), and area postrema syndrome (6.3%). MRI scans of the brain were abnormal in 53.1% of the cohort, with abnormalities in VEP and CSF seen in 42.0% of eyes and 78.1% of patients, respectively. Cervical cords in combination with cervicothoracic cords were the most common sites of cord involvement. Three patients among the TM patients also had spinal movement disorders. All patients received rituximab as a disease-modifying therapy. Two relapses and one mortality were documented in a one-year follow-up.</p><p><strong>Conclusion: </strong>Kashmiri NMOSD patients largely follow global patterns with a female preponderance, high AQP4 positivity, and a predominance of cervical longitudinally extensive TM. Optic Neuritis was seen in relatively younger patients. Our findings also highlight the utility of rituximab in treating NMOSD in resource-poor settings.</p>","PeriodicalId":72904,"journal":{"name":"Encephalitis (Seoul, Korea)","volume":" ","pages":"65-74"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13368394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of nonconvulsive status epilepticus in the ictal-interictal continuum using artificial intelligence: a prospective observational cohort study.","authors":"Sungyeong Ryu, Dong Ah Lee, Kang Min Park","doi":"10.47936/encephalitis.2025.00157","DOIUrl":"10.47936/encephalitis.2025.00157","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to investigate differences in functional connectivity between patients on the ictal-interictal continuum (IIC) with nonconvulsive status epilepticus (NCSE) versus those with coma-IIC, and to evaluate whether machine learning based on these connectivity measures was able to distinguish between these two groups.</p><p><strong>Methods: </strong>We prospectively enrolled patients with IIC electroencephalography (EEG) patterns and classified them into NCSE or coma-IIC groups according to the Salzburg criteria and clinical information. We analyzed functional connectivity based on EEG using graph theory. For deep learning, EEG signals were transformed into time-frequency images using short-time Fourier transforms. We investigated differences in functional connectivity between the two groups.</p><p><strong>Results: </strong>We enrolled 72 patients on the IIC. Of the 72 patients, 53 patients had NCSE, and 19 had coma-IIC. Patients with NCSE had decreased global functional connectivity in all frequency bands compared to patients with coma-IIC. Global efficiency was significantly lower in the NCSE group than the coma-IIC group (e.g., gamma band, 0.258 vs 0.350; p = 0.001), and local efficiency was consistently decreased across all frequency bands in the NCSE group (all p ≤ 0.01). Machine learning based on these measures classified patients with NCSE and those with coma-IIC with an accuracy of 92.8%, while the accuracy of the convolutional neural network model to distinguish between them was 73.9%.</p><p><strong>Conclusion: </strong>We demonstrated that graph-theoretical functional connectivity derived from EEG data differs significantly between patients with NCSE and those with coma-IIC. Furthermore, our results confirm the feasibility of using machine learning models based on these connectivity measures to effectively distinguish between these two conditions.</p>","PeriodicalId":72904,"journal":{"name":"Encephalitis (Seoul, Korea)","volume":" ","pages":"48-59"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147464104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of transcranial direct current stimulation in refractory seizures in tuberculous meningitis: a case report.","authors":"Anadi Mishra, Imran Rizvi, Ravindra Garg, Harish Nigam, Rajarshi Chakraborty, Ankit Khetan","doi":"10.47936/encephalitis.2025.00108","DOIUrl":"10.47936/encephalitis.2025.00108","url":null,"abstract":"<p><p>Tuberculous meningitis (TBM) is a devastating form of tuberculosis with high mortality and long-term neurological sequelae. Seizures, including refractory status epilepticus, are common complications and portend a poor prognosis. While neuromodulation techniques such as vagus nerve and deep brain stimulation have been used in refractory epilepsy, there are no prior reports of transcranial direct current stimulation (tDCS) in refractory seizures related to TBM. We report a 19-year-old woman with pulmonary tuberculosis who developed TBM with multiple central nervous system tuberculomas and refractory status epilepticus unresponsive to multiple antiseizure medications, intravenous anesthetics, and steroids. A structured course of cathodal tDCS was initiated (10 sessions, once daily for 10 days, 2 mA amplitude, 20 minutes per session, ramp-up 10 seconds, impedance 4 kΩ; cathode over electroencephalogram-localized epileptic focus, anode over contralateral supraorbital region). Following the intervention, sedation was successfully tapered, and the patient was discharged seizure-free on oral therapy. At the 1-month follow-up, she remained seizure-free and demonstrated clinical improvement, with no new neurological deficits. This case demonstrates the feasibility and potential benefit of tDCS as an adjunctive therapy for refractory seizures in TBM. While causality could not be established, this is the first report of tDCS application in TBM-related seizures. Controlled studies with objective neurophysiological endpoints are warranted.</p>","PeriodicalId":72904,"journal":{"name":"Encephalitis (Seoul, Korea)","volume":" ","pages":"60-64"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preliminary evidence of cardiac dysfunction in subacute sclerosing panencephalitis: a systematic review and meta-analysis.","authors":"Nikhil Pandey, Neetu Rani Dhiman, Deepika Joshi, Dharma Raj, Niraj Kumar Srivastava, Anand Kumar, Varun Kumar Singh","doi":"10.47936/encephalitis.2025.00122","DOIUrl":"10.47936/encephalitis.2025.00122","url":null,"abstract":"<p><strong>Purpose: </strong>Subacute sclerosing panencephalitis (SSPE) is a catastrophic neurological disorder that typically presents in infancy and early adolescence. Cardiac arrhythmia in SSPE is a significant but often under-recognized complication of the disease. The persistent measles virus infection that characterizes SSPE can have widespread effects on the central nervous system, including areas that regulate autonomic function, which in turn can impact cardiac rhythm. In this article, we aim to comprehensively review articles describing cardiac dysfunction associated with SSPE.</p><p><strong>Methods: </strong>We conducted a literature search in PubMed, Scopus, ProQuest, Emerald, and Google Scholar databases of articles published till October, 2025, identified items for review, and conducted a meta-analysis.</p><p><strong>Results: </strong>A total of 947 results were identified across five databases, with 378 studies initially screened, and 569 articles were excluded (10 duplicates and 559 unrelated to the study). Only 4 articles met the eligibility criteria. Our meta-analysis of the three studies showed a pooled mean difference of 11.20 beats per minute (95% confidence interval, 5.52-16.88), with case groups having significantly higher heart rates than controls.</p><p><strong>Conclusion: </strong>The few available studies provide preliminary evidence suggesting that cardiac autonomic disturbances, including elevated heart rates and reduced HRV, occur in a subset of patients with SSPE. More rigorously designed investigations are needed to clarify the prevalence, mechanisms, and clinical impact of cardiac dysfunction in SSPE.</p>","PeriodicalId":72904,"journal":{"name":"Encephalitis (Seoul, Korea)","volume":" ","pages":"40-47"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147367416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glymphatic system dysfunction in epilepsy: a review of mechanisms and clinical evidence.","authors":"Jung-Ick Byun","doi":"10.47936/encephalitis.2025.00171","DOIUrl":"10.47936/encephalitis.2025.00171","url":null,"abstract":"<p><p>The glymphatic system is a glial-dependent waste clearance pathway, a perivascular network responsible for the clearance of metabolic waste and neurotoxic proteins through cerebrospinal fluid-interstitial fluid exchange. It may play a critical role in the pathophysiology of various neurological diseases, including epilepsy. Neuroinflammation and blood-brain barrier disruption associated with seizures may impair glymphatic function, while impaired waste clearance may, in turn, facilitate epileptogenesis. Diffusion tensor imaging analysis along the perivascular space (DTI-ALPS) has emerged as a noninvasive imaging marker of glymphatic function. Patients with focal and generalized epilepsy consistently demonstrate reduced DTI-ALPS indices in comparison to healthy controls, with greater impairment associated with older age, longer disease duration, cognitive dysfunction, and drug-resistant epilepsy.</p>","PeriodicalId":72904,"journal":{"name":"Encephalitis (Seoul, Korea)","volume":" ","pages":"33-39"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In coronavirus patients with impaired consciousness, comprehensive and repeated examinations are necessary to determine the cause.","authors":"Carla A Scorza, Fulvio A Scorza, Josef Finsterer","doi":"10.47936/encephalitis.2025.00150","DOIUrl":"10.47936/encephalitis.2025.00150","url":null,"abstract":"","PeriodicalId":72904,"journal":{"name":"Encephalitis (Seoul, Korea)","volume":" ","pages":"31-32"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147464370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fatal retroperitoneal hemorrhage following enoxaparin administration in a patient with autoimmune encephalitis: a case report.","authors":"Ji-Ye Jeon, Byunghyuk Yu","doi":"10.47936/encephalitis.2025.00087","DOIUrl":"10.47936/encephalitis.2025.00087","url":null,"abstract":"<p><p>We report a fatal case of retroperitoneal hemorrhage following standard-dose enoxaparin treatment in a patient with autoimmune encephalitis presenting with new-onset refractory status epilepticus. A 61-year-old female developed deep vein thrombosis during treatment and received enoxaparin, following which she experienced sudden hypovolemic shock due to massive retroperitoneal bleeding. Despite intensive care, the patient died of multiorgan failure. To our knowledge, this is the first such case reported in South Korea. Clinicians should be aware of the rare but serious risk of hemorrhage when administering anticoagulants to patients with autoimmune encephalitis and other complex and evolving clinical conditions.</p>","PeriodicalId":72904,"journal":{"name":"Encephalitis (Seoul, Korea)","volume":" ","pages":"13-18"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12800451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145901679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of poor outcomes in neuroleptospirosis and differentiation from tuberculous meningitis: a cross-sectional analysis.","authors":"Abhishek Dixit","doi":"10.47936/encephalitis.2025.00073","DOIUrl":"10.47936/encephalitis.2025.00073","url":null,"abstract":"<p><strong>Purpose: </strong>This study was performed to identify predictors of poor outcomes in neuroleptospirosis and delineate key clinical, laboratory, and imaging parameters that differentiate it from tuberculous meningitis (TBM).</p><p><strong>Methods: </strong>This cross-sectional study included 50 patients with neuroleptospirosis and 150 with TBM at a tertiary care center in North India (2021-2023). Data on demographics, clinical features, cerebrospinal fluid (CSF) profiles, and neuroimaging findings were analyzed. Statistical comparisons were performed using independent t-tests and the Fisher exact test.</p><p><strong>Results: </strong>Neuroleptospirosis patients had significantly lower CSF protein (89.00 ± 63.89 vs 172.00 ± 145.17 mg/dL, p &lt; 0.001), higher CSF glucose (74.20 ± 30.22 vs 47.00 ± 21.81 mg/dL, p &lt; 0.001), and fewer magnetic resonance imaging abnormalities (eg, infarct: 2% vs 51%, p &lt; 0.001). Fever, headache, and neck stiffness were less common in neuroleptospirosis (p &lt; 0.001). Age and CSF cell counts showed marginal differences (p = 0.054 and p = 0.071, respectively). Mortality and severe disability were associated with older age, hypoalbuminemia, and delayed hospitalization.</p><p><strong>Conclusion: </strong>Distinct CSF profiles and neuroimaging patterns can differentiate neuroleptospirosis from TBM. Early clinical recognition of these parameters should improve diagnostic accuracy and outcomes.</p>","PeriodicalId":72904,"journal":{"name":"Encephalitis (Seoul, Korea)","volume":" ","pages":"8-12"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12800448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145662945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A narrative review of antiseizure medication adherence in epilepsy: determinants to clinical implications.","authors":"Yongmoo Kim, Yoonhyuk Jang","doi":"10.47936/encephalitis.2025.00129","DOIUrl":"10.47936/encephalitis.2025.00129","url":null,"abstract":"<p><p>Achieving optimal seizure control without recurrence is a critical goal in epilepsy. When evaluating whether treatment is effective, medication adherence must be carefully considered but has traditionally been overlooked. In this study, we introduce commonly used definitions of medication adherence and examine adherence findings in epilepsy and other chronic diseases. Factors influencing adherence are analyzed according to three domains: the characteristics of the medication itself, patient-related factors, and environmental or socioeconomic influences. Considering not only the pharmacologic properties of antiseizure medications but also the roles of social and economic support in clinical practice may help reduce the risk of breakthrough seizures and early mortality in patients with epilepsy.</p>","PeriodicalId":72904,"journal":{"name":"Encephalitis (Seoul, Korea)","volume":"6 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12800450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atypical manifestation of human herpes virus-6 encephalitis with extra-limbic lesions: a case report.","authors":"Soo Hyun Ahn, Seon-Jae Ahn, Kon Chu","doi":"10.47936/encephalitis.2025.00115","DOIUrl":"10.47936/encephalitis.2025.00115","url":null,"abstract":"<p><p>Human herpesvirus-6 (HHV-6) encephalitis represents a serious opportunistic infection in immunocompromised patients that is associated with substantial mortality and long-term neurological sequelae. The disease most often involves the limbic system, with typical neuroimaging findings restricted to the hippocampal and amygdaloid structures. Here, we describe a rare case of HHV-6 encephalitis presenting with atypical imaging features, which demonstrated near-complete resolution following ganciclovir therapy. This case underscores that HHV-6 encephalitis is not invariably confined to the limbic system and highlights the importance of prompt antiviral therapy in preventing irreversible neurological damage.</p>","PeriodicalId":72904,"journal":{"name":"Encephalitis (Seoul, Korea)","volume":"6 1","pages":"19-23"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12800449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}