Encephalitis (Seoul, Korea)最新文献

{"title":"Renal tubular acidosis as the initial presentation of Sjögren syndrome complicated by iatrogenic central pontine myelinolysis: a case report.","authors":"Hussein Algahtani, Bader Shirah, Mohamed Najm Aldeen Alameen, Saeed Almajadiah, Abdulrahman Bin Saeed","doi":"10.47936/encephalitis.2025.00059","DOIUrl":"10.47936/encephalitis.2025.00059","url":null,"abstract":"<p><p>Primary Sjögren syndrome is a chronic autoimmune disorder that primarily affects the exocrine glands and may present with extraglandular manifestations, including renal tubular acidosis (RTA). We report the case of a 28-year-old postpartum female who presented with rapidly progressive limb weakness and severe hypokalemia; she was ultimately diagnosed with RTA as the initial manifestation of primary Sjögren syndrome. During treatment with intravenous sodium bicarbonate, the patient developed acute hypernatremia, which was subsequently complicated by central pontine myelinolysis (CPM). This iatrogenic neurological event highlights the potential risks associated with rapid correction of metabolic acidosis in autoimmune conditions. The patient was treated with corticosteroids, rituximab, and intravenous immunoglobulin, resulting in marked clinical and radiological improvement. This case underscores the need for caution when rebalancing electrolytes in patients with autoimmune-mediated RTA and contributes to the limited literature on CPM in this context. Early recognition and appropriate immunosuppressive therapy may play a role in optimizing neurological recovery.</p>","PeriodicalId":72904,"journal":{"name":"Encephalitis (Seoul, Korea)","volume":"6 1","pages":"24-29"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12800452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145968017","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":"Encephalopathy and central nervous system symptoms of coronavirus disease 2019: a case series from northern India.","authors":"Abhishek Verma, Deepak Kumar","doi":"10.47936/encephalitis.2024.00164","DOIUrl":"10.47936/encephalitis.2024.00164","url":null,"abstract":"<p><p>The coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) results in multi-organ involvement, with increasing evidence of neurological manifestations such as encephalopathy, encephalitis, stroke, and Guillain-Barré syndrome. This case series reports nine patients admitted between November 2020 and May 2021 with COVID-19-related encephalitis, primarily presenting with altered sensorium and other neurological symptoms. Clinical, laboratory, and cerebrospinal fluid (CSF) analysis as well as neuroimaging findings were reviewed. The patients, aged 30 to 88 years (mean age, 64 years), presented with fever, cough, shortness of breath, and altered sensorium. Neurological examination revealed abnormalities such as altered muscle tone, upgoing plantars, and neck rigidity. Laboratory results showed elevated levels of D-dimer, lactate dehydrogenase, and interleukin-6, indicating systemic inflammation and hypercoagulability. CSF was acellular with normal protein and glucose levels, and SARS-CoV-2 reverse transcription polymerase chain reaction was negative. Neuroimaging varied, with some patients showing normal computed tomography and others demonstrating mild meningeal enhancement or lacunar infarcts. The patients received supportive care, including oxygen therapy, remdesivir, dexamethasone, and ceftriaxone. Outcomes ranged from complete recovery to death, with those over 60 years of age or with significant comorbidities facing a higher mortality risk. Neurological manifestations, particularly encephalopathy, are common in COVID-19, with potential mechanisms involving systemic inflammation and microvascular damage rather than direct viral invasion of the central nervous system. Early recognition and management are crucial, especially in older patients or those with comorbidities, in order to reduce the risk of severe complications and mortality.</p>","PeriodicalId":72904,"journal":{"name":"Encephalitis (Seoul, Korea)","volume":" ","pages":"109-114"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12554388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202181","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":"Anti-N-methyl-ᴅ-aspartate receptor encephalitis in India: a case series and review of the literature.","authors":"Anadi Mishra, Rajarshi Chakraborty, Harish Nigam, Rajesh Verma, Neeraj Kumar, Ravi Uniyal, Imran Rizvi, Ankit Khetan, Arjun Bal Kp","doi":"10.47936/encephalitis.2025.00052","DOIUrl":"10.47936/encephalitis.2025.00052","url":null,"abstract":"<p><strong>Purpose: </strong>Anti-N-methyl-ᴅ-aspartate receptor encephalitis (NMDARE) is an autoimmune disorder of the central nervous system characterized by subacute- onset neurocognitive disorders, seizures, movement disorders, and prominent neuropsychiatric features affecting young adults. This case series describes the clinical profile, neuroimaging features, and outcomes in NMDARE patients and attempts to compare its findings with previously published studies in an Indian setting.</p><p><strong>Methods: </strong>All consecutive patients diagnosed with definite NMDARE over a 2-year period were evaluated and followed up with. A comprehensive literature review was conducted in PubMed, Scopus, Embase, and Google Scholar, covering studies published up to January 2025.</p><p><strong>Results: </strong>The case series included six patients (four females) aged 10-19 years presenting with super-refractory status epilepticus, dystonia, rubral tremors, and psychiatric symptoms. Tumor screening was negative in all cases. Magnetic resonance imaging of the brain revealed white matter hyperintensities in the medial temporal lobe, periventricular white matter, basal ganglia, and midbrain. Electroencephalogram abnormalities included diffuse slowing, extreme delta brush, and epileptiform discharges. Patients responded to high-dose intravenous methylprednisolone and intravenous immunoglobulin in most cases, with rituximab and cyclophosphamide administered successfully in refractory cases. Our review of Indian literature on NMDARE revealed 60 studies (115 patients), among which 48 case reports were excluded and 12 clinical studies and case series were included. Included patients were aged 2-29 years and mostly female, with similar clinical and imaging profiles to our population and a comparable low yield of tumor screening. Prognosis was good with immunotherapy, with few fatality reports.</p><p><strong>Conclusion: </strong>NMDARE patients present with protean clinical manifestations and difficult diagnostic and therapeutic challenges, resulting in an unclear prognosis. Early recognition, aggressive immunotherapy, and regular follow-up are key to better outcomes.</p>","PeriodicalId":72904,"journal":{"name":"Encephalitis (Seoul, Korea)","volume":"5 4","pages":"93-100"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12554389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260018","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":"Impact of standardized electroencephalography terminology education among early-career neurologists in Korea: a single-group pretest-posttest study.","authors":"Kyung-Il Park, Sang Bin Hong, Hansang Lee","doi":"10.47936/encephalitis.2025.00101","DOIUrl":"10.47936/encephalitis.2025.00101","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluated the effectiveness of implementing standardized electroencephalography (EEG) terminology and education on improving interpretation skills among non-English speakers.</p><p><strong>Methods: </strong>EEGs were collected retrospectively from 16 critically ill patients and two alert epilepsy patients (30-minute sessions) and read by 10 neurologists. After initial interpretation, a learning module was provided to the neurologists. One week later, the neurologists reinterpreted the same EEGs randomly reordered. The interpretation accuracies of 144 items were scored as correct, similar, incorrect, or not recognized based on consensus answers.</p><p><strong>Results: </strong>Overall scores improved significantly after learning modules were completed, increasing from 88.8 ± 23.1 to 118.2 ± 39.2 (p = 0.037). Performance improvement was also observed, regardless of years of clinical experience treating patients with epilepsy. However, more experienced raters tended to have higher inter-rater agreement. The baseline correct answer rates for rhythmic delta activity (RDA), periodic discharges (PD), sporadic epileptiform discharge (ED), and electrographic seizures (ES) were 42.5%, 50%, 60.0%, and 20.0%, respectively. After the learning modules were completed, correct answer rates increased by 21.4% for RDA (p = 0.11), 11.1% for PD (p = 0.06), and 28.1% for ES (p = 0.02), but decreased by 11.1% for sporadic ED (p = 0.02). Specifically, the accuracy for generalized PD improved significantly after learning (p = 0.04). Most minor items except location were often missed even after learning.</p><p><strong>Conclusion: </strong>Education is imperative for standardizing EEG descriptions. As such, developing educational modules that emphasize minor items including prevalence, frequency, duration, and amplitude will broaden the recognition of EEG features, improving the quality of future research and patient care.</p>","PeriodicalId":72904,"journal":{"name":"Encephalitis (Seoul, Korea)","volume":" ","pages":"101-108"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12554387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202212","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":"Subacute herpes simplex virus type 1 encephalitis: a case report.","authors":"Maria Lypiridou, Konstantinos Kalafatakis, Kyriaki Astara, Anna Margoni, Eleftheria Karakatsani, Georgios Stouraitis","doi":"10.47936/encephalitis.2025.00024","DOIUrl":"10.47936/encephalitis.2025.00024","url":null,"abstract":"<p><p>Herpes simplex encephalitis (HSE) is a potentially fatal infection of the brain parenchyma with high mortality rates when left untreated. It typically affects the medial temporal lobe, and patients commonly present with headache, fever, and altered mental status. The combination of clinical findings and brain imaging should raise suspicion, whereas cerebrospinal fluid (CSF) analysis should establish the diagnosis. In a few cases, HSE presents with subacute progression, making diagnosis more challenging. Treatment with acyclovir should begin immediately after HSE is suspected; otherwise, the mortality rate is high. Herein, we present a rare case of HSE with a subacute course admitted to the emergency department because of an episode of syncope with concomitant bradycardia. HSE symptoms developed gradually during the first week after hospitalization. Typical imaging findings, CSF analysis, and polymerase chain reaction results positive for herpes simplex virus-1 confirmed a diagnosis of HSE. The insidious symptomatology of this case led to delayed acyclovir administration and the patient unfortunately died 4 days after diagnosis.</p>","PeriodicalId":72904,"journal":{"name":"Encephalitis (Seoul, Korea)","volume":"5 3","pages":"77-81"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602356","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 case of Hashimoto's encephalopathy mimicking posterior reversible encephalopathy syndrome.","authors":"Yoonjeong Na, Jung-Ju Lee, Byung-Kun Kim, Kyusik Kang, Woong-Woo Lee, Ilhan Yoo, Namoh Kim, Michelle Sojung Youn","doi":"10.47936/encephalitis.2025.00038","DOIUrl":"10.47936/encephalitis.2025.00038","url":null,"abstract":"<p><p>Hashimoto's encephalopathy (HE) is a rare disease of the central nervous system characterized by diverse neurological symptoms associated with elevated levels of antithyroid antibodies. Posterior reversible encephalopathy syndrome (PRES) is a clinico-radiological syndrome characterized by typical manifestations such as severe headache, altered mental status, visual impairment, seizures, and vasogenic edema. We experienced a patient with HE presenting with PRES who showed remarkable improvement subsequent to treatment with anti-seizure medication and corticosteroids. This case report underscores potential pathomechanisms and clinical significance.</p>","PeriodicalId":72904,"journal":{"name":"Encephalitis (Seoul, Korea)","volume":" ","pages":"82-86"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546432","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":"Anti-N-methyl-ᴅ-aspartate receptor encephalitis preceding stroke: report of an unusual case with literature review.","authors":"Arpan Mitra, Niraj Kumar Srivastava, Ankur Vivek, Vijaya Nath Mishra, Abhishek Pathak","doi":"10.47936/encephalitis.2025.00017","DOIUrl":"10.47936/encephalitis.2025.00017","url":null,"abstract":"<p><p>Anti-N-methyl-ᴅ-aspartate (anti-NMDA) receptor encephalitis is a well-known autoimmune encephalitis caused by antibodies against the GluN1 subunit of the anti-NMDA receptor (anti-NMDAR). Stroke, characterized by abrupt focal neurological deficits due to ischemic or hemorrhagic vascular insults, is rarely preceded by anti-NMDAR encephalitis. Here, we described a case of a 69-year-old female without any prior comorbidities who presented with acute stroke and left hemiparesis with a history of recent onset of neuropsychiatric symptoms. Her cerebrospinal fluid was positive for anti-NMDAR antibody, and significant improvement was noticed after the initiation of immunotherapy. In this patient, stroke occurred following anti-NMDAR encephalitis; however, the pathophysiological link between the two remains unclear. This case presents an interesting and rare clinical intersection between stroke and anti-NMDAR encephalitis, highlighting the difficulty of neurological diagnosis. Due to the unusual association of such pathological conditions, this case contributes to the broader understanding of potential connections between stroke and autoimmune encephalitis, emphasizing the need for a multidisciplinary approach to diagnosis and management.</p>","PeriodicalId":72904,"journal":{"name":"Encephalitis (Seoul, Korea)","volume":"5 3","pages":"71-76"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602355","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":"Tuberculous meningitis initially presented with low levels of pleocytosis and protein in the cerebrospinal fluid: a case report.","authors":"Hyung-Kyum Kim, Byung-Kun Kim, Jung-Ju Lee, Kyusik Kang, Woong-Woo Lee, Ilhan Yoo, Namoh Kim","doi":"10.47936/encephalitis.2025.00010","DOIUrl":"10.47936/encephalitis.2025.00010","url":null,"abstract":"<p><p>Tuberculous meningitis (TBM) is fatal unless treated promptly. Nonconvulsive status epilepticus (NCSE) may cause altered consciousness in patients with TBM. A 25-year-old female presented to the emergency department with a headache and fever along with multiple associated symptoms that had developed 2 days prior. Based on clinical findings, brain imaging, and cerebrospinal fluid (CSF) examination, she was tentatively diagnosed with viral meningitis. Later, she developed altered consciousness with focal seizures, and follow-up CSF examination findings and electroencephalography were consistent with NCSE complicated by TBM. We encountered a patient with TBM who exhibited initial atypical CSF findings and NCSE, and we report the case here and discuss the pathomechanisms.</p>","PeriodicalId":72904,"journal":{"name":"Encephalitis (Seoul, Korea)","volume":" ","pages":"67-70"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058196","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 case report of anti-N-methyl-ᴅ-aspartate receptor encephalitis: prioritizing clinical symptoms over diagnostic test results.","authors":"Wankiun Lee","doi":"10.47936/encephalitis.2025.00045","DOIUrl":"10.47936/encephalitis.2025.00045","url":null,"abstract":"<p><p>Anti-N-methyl-ᴅ-aspartate receptor (NMDAR) encephalitis is the most common type of autoimmune encephalitis; however, the frequently negative initial diagnostic test results for NMDAR complicate its diagnosis. A 40-year-old man with no underlying medical conditions presented with psychiatric symptoms lasting 3 weeks; initial cerebrospinal fluid (CSF) examination, brain magnetic resonance imaging, and electroencephalography findings demonstrated no significant abnormalities. He subsequently developed symptoms characteristic of anti-NMDAR encephalitis, prompting the initiation of immunotherapy before the presence of CSF anti-NMDAR antibodies was confirmed. After receiving intravenous immunoglobulin (IVIG) followed by rituximab therapy, his symptoms improved dramatically. He was discharged 21 days after hospital admission in a healthy condition. The presence of CSF anti-NMDAR antibodies was confirmed post-discharge. This case highlights the importance of maintaining autoimmune encephalitis as a differential diagnosis in cases with similar presentations and in which initial test results identify no abnormalities. In these cases, clinical diagnoses and responses to therapy should supersede diagnostic test findings.</p>","PeriodicalId":72904,"journal":{"name":"Encephalitis (Seoul, Korea)","volume":"5 3","pages":"87-91"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602354","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":"An interesting case of subacute sclerosing panencephalitis presenting with Balint's syndrome and dysautonomia.","authors":"Swati Parida, Nikhil Pandey, Anand Kumar, Varun Kumar Singh, Neetu Rani Dhiman, Niraj Kumar Srivastava, Deepika Joshi","doi":"10.47936/encephalitis.2024.00115","DOIUrl":"10.47936/encephalitis.2024.00115","url":null,"abstract":"<p><p>Subacute sclerosing panencephalitis (SSPE) is a rare, progressive neurodegenerative disorder caused by persistent aberrant measles virus infection. It is characterized by behavioral changes, cognitive decline with deterioration in academic performance, visual dysfunction, focal or generalized seizures ,myoclonus, spasticity, mutism and akinesia ultimately leading to a vegetative state. Balint's syndrome, characterized by the triad of simultagnosia, optic ataxia, and oculomotor apraxia, as an initial presenting feature of SSPE is rare. Autonomic dysfunction in SSPE is attributed to central autonomic involvement, with decreased heart rate variability a predictor for arrhythmia and sudden cardiac death. We report an unusual case of a 22-year-old male presenting with features suggestive of Balint's syndrome. Myoclonus and cognitive decline appeared 6 months after the first onset of symptoms, along with autonomic dysfunction. Thereafter, rapid progression of symptoms was noted. Cerebrospinal fluid and electroencephalography after the first symptom onset were consistent with a diagnosis of SSPE. The patient ultimately succumbed to his illness. Thus we highlight atypical presentation of SSPE with autonomic dysfunction. A high index of suspicion is needed for prompt and timely intervention.</p>","PeriodicalId":72904,"journal":{"name":"Encephalitis (Seoul, Korea)","volume":" ","pages":"53-56"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597282","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}