ABSTRACT
Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis has clinical features of psychiatric symptoms, loss of memory, seizure, dyskinesia and autonomic dysfunction. While Anti-NMDA receptor encephalitis was initially reported in young women with ovarian teratoma, viral infections can trigger anti-NMDA receptor encephalitis as well. Among them, herpes virus is the most common. We report a patient who developed the anti-NMDA receptor encephalitis 47 days after herpes virus encephalitis, which is, to our knowledge, the first case in Korea.
Subject(s)
Female , Humans , Anti-N-Methyl-D-Aspartate Receptor Encephalitis , Dyskinesias , Encephalitis , Encephalitis, Herpes Simplex , Herpes Simplex , Korea , Memory , Seizures , Simplexvirus , TeratomaABSTRACT
OBJECTIVE: Cerebrospinal fluid (CSF) examination is mandatory whenever central nervous system (CNS) infection is suspected. However, pleocytosis is not detected in a substantial number of suspected patients who undergo CSF examination. This study aimed to identify parameters that can aid in predicting negative CSF examination results (defined as a white blood cell count of 0.7, and the best cutoff values were 6.0 (accuracy 70.3%) and 12.7 mg/L (accuracy 76.2%), respectively. CONCLUSION: The neutrophil-to-lymphocyte ratio ≥6 and C-reactive protein level ≥12.7 mg/L was significantly associated with negative CSF examination result.
Subject(s)
Humans , C-Reactive Protein , Central Nervous System Infections , Central Nervous System , Cerebrospinal Fluid , Hematologic Tests , Leukocyte Count , Leukocytes , Leukocytosis , Lymphocytes , Neutrophils , Spinal PunctureABSTRACT
Many kinds of degenerative, psychiatric, and cerebrovascular diseases can mimic behavioral variant frontotemporal dementia. We present a 73-year-old woman who presented with apathy, inappropriate social behavior, and persecutory delusion. A neuropsychological examination revealed frontal/executive dysfunction with relative sparing of episodic memory. Magnetic resonance imaging and F-18 fluorodeoxyglucose positron-emission tomography produced normal findings. However, magnetic resonance angiography revealed severe right internal carotid stenosis. After carotid stenting, her behavioral symptoms disappeared and did not recur during an 18-month follow-up.
Subject(s)
Aged , Female , Humans , Apathy , Behavioral Symptoms , Carotid Artery, Internal , Carotid Stenosis , Cerebrovascular Disorders , Delusions , Follow-Up Studies , Frontotemporal Dementia , Magnetic Resonance Angiography , Magnetic Resonance Imaging , Memory, Episodic , Positron-Emission Tomography , Social Behavior , StentsABSTRACT
Ischemic stroke caused by spontaneous thrombosis of posterior inferior cerebellar artery (PICA) aneurysm has been rarely reported. A 52-year-old man presented with sudden headache, dizziness, and gait disturbance. Diffusion-weighted MRI showed acute infarction in left PICA territory. A saccular aneurysm with internal thrombus at the distal PICA was detected by CT angiography and conventional angiography. The thrombus resolved spontaneously at 2 months after stroke onset with aspirin medication. At that time, endovascular coiling was underwent successfully to prevent aneurysmal rupture.