From: MOG antibody seropositivity in a patient with encephalitis: beyond the classical syndrome
Case | 1 | 2 | 3 | 4 | 5 | 6 |
---|---|---|---|---|---|---|
Onset | fever, headache, confusion, altered consciousness, unsteady gait | dizziness | eye pain and visual loss | seizure | involuntary movemet | headache and abnormal behavior |
Seizures | no | yes | yes | yes | yes | yes |
Optic neuritis | no | yes | yes | yes | no | no |
Myelitis | no | no | no | no | no | no |
CSF | increased cells and proteins | increased cells, negative at a second control | increased cells | increased cells | increased cells and proteins | increased cells and proteins |
First Brain MRI | subcortical, periventricular, cortical, white matter, thalamus, basal ganglia, internal capsule, pons | frontal cortex | frontoparietal cortex | frontoparietal cortex | parietal cortex | emisphere cortex |
Second Brain MRI | reduction of preexisting lesios | corpus callosum, cingulate gyri, frontal lobes | negative | optic nerve, emispheric cortex | negative | negative |
Third Brain MRI | Â | third ventricle, cerebral aqueduct, thalamus, nucleus basalis | Â | negative | Â | Â |
Fourth Brain MRI | Â | reduction of preexisting lesios | Â | Â | Â | Â |
Clinical symptoms | wide-based unsteady gate, reduced level of consciousness, diffuse skin swelling and pustules with enanthema | headache, paraparesis/paraplegia, memory decline, lethargy | delirium, paranoia, hallucination, anorexia | eye pain, visual loss, dysuria | headache, disorientation | agitation, violent behavior, delirium, emotional incontinence, aphasia, hemiparesis |
Treatment | acyclovir, antibiotics, immunoglobulins | methylprednisolone and acyclovir, oral prednisolone | methylprednisolone, prednisolone, antiepilepsy drugs | methylprednisolone, prednisolone, antiepilepsy drugs | acyclovir, antibiotics, antimycotic, dexamethasone, prednisolone, antiepilepsy drugs | methylprednisolone, prednisolone, antiepilepsy drugs |
Relapses | no | yes | yes | no | no | yes |
Outcome | almost full recovery | full recovery | full recovery | full recovery | full recovery | full recovery |