Résumé
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.
Sujets)
Femelle , Humains , Encéphalite à anticorps anti-récepteur N-méthyl-D-aspartate , Dyskinésies , Encéphalite , Encéphalite à herpès simplex , Herpès , Corée , Mémoire , Crises épileptiques , Simplexvirus , TératomeRésumé
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.
Sujets)
Humains , Protéine C-réactive , Infections du système nerveux central , Système nerveux central , Liquide cérébrospinal , Tests hématologiques , Numération des leucocytes , Leucocytes , Hyperleucocytose , Lymphocytes , Granulocytes neutrophiles , Ponction lombaireRésumé
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.
Sujets)
Humains , Adulte d'âge moyen , Anévrysme , Angiographie , Artères , Acide acétylsalicylique , Infarctus cérébral , Sensation vertigineuse , Démarche , Céphalée , Infarctus , Imagerie par résonance magnétique , Pica , Rupture , Accident vasculaire cérébral , ThromboseRésumé
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.