Adult ; Female ; Humans ; Limbic Encephalitis ; diagnosis ; etiology ; Ovarian Neoplasms ; complications ; diagnosis ; Paraneoplastic Cerebellar Degeneration ; diagnosis ; etiology

BACKGROUND: The aim of this study was to investigate the clinical features of paraneoplastic limbic encephalitis (PLE) with small cell lung cancer (SCLC) and improve clinical diagnosis and treatment. METHODS: The clinical data of 15 patients with SCLC combined with PLE from January 1980 to May 2017 were collected from Beijing Union Hospital. Their symptoms and laboratory data were analyzed and the prognosis of the patients was followed. RESULTS: PLE is a rare disease, the incidence rate in SCLC is about 0.842%. The data may be underestimated because of misdiagnose or missed diagnosis; High incidence crowd of the disease is the middle-aged male smoker, the tumor-node-metastasis (TNM) stages of them are later than others; Typical neurological symptoms include varying degrees of short-term memory loss, seizures and varying degrees of mental disorders; neurological symptoms usually occur before the onset of cancer or respiratory symptoms appear, an average of about 2 months be taken from onset to diagnosis; Serum antibody (anti-Hu, GABA-R-Ab), cerebrospinal fluid, head magnetic resonance imaging (MRI) and electroencephalogram (EEG) of the patients has abnormalities; Videography, especially computed tomography (CT) is a good means of screening the primary tumor, pathology diagnosis mainly rely on bronchoscopy; The treatment of primary tumors can be more effective in alleviating the nervous system symptoms than immunotherapy. CONCLUSIONS Paraneoplastic limbic encephalitis is a rare paraneoplastic syndrome in nervous system caused by malignant neoplasms often characterized by facial neurological symptoms. The disease are usually associated with lung cancer (especially SCLC). Its nervous system symptoms occur earlier than the tumor diagnosis. Early diagnosis and treatment for primary tumors will increase the benefit.
Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Limbic Encephalitis ; complications ; Lung Neoplasms ; complications ; diagnosis ; therapy ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Small Cell Lung Carcinoma ; complications ; diagnosis ; therapy

OBJECTIVETo report 21 cases of postinfectious encephatitis according to ICD-NA, postinfectious/parainfectious encephalitis is an independent disease.

METHODSUsing the uniform criteria provided by The Council of State and Territorial Epidemiologists (CSTE) and Centers for Disease Control and Prevention (CDC), we diagnosed postinfectious encephalitis among patients admitted to The First Hospital of Harbin Medical University and analyzed the characteristics of these cases.

RESULTSAll the patients had histories of preceding infection, and most of them suffered from mental and conscious disorders. Adrenocortical hormone was effective.

CONCLUSIONSPostinfectious encephalitis is an independent disease. According to this article, about 10% patients with encephalitis admitted to our hospital are postinfectious.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Encephalitis ; diagnosis ; drug therapy ; etiology ; Female ; Humans ; Infection ; complications ; Male ; Middle Aged

Child Behavior Disorders ; etiology ; Child, Preschool ; Dyskinesias ; etiology ; Encephalitis ; complications ; diagnosis ; Female ; Humans ; Sleep Wake Disorders ; etiology

Reversible focal lesions on the splenium of the corpus callosum (SCC) have been reported in patients with mild encephalitis/encephalopathy caused by various infectious agents, such as influenza, mumps, adenovirus, Varicella zoster, Escherichia coli, Legionella pneumophila, and Staphylococcus aureus. We report a case of a reversible SCC lesion causing reversible encephalopathy in nonfulminant hepatitis A. A 30-year-old healthy male with dysarthria and fever was admitted to our hospital. After admission his mental status became confused, and so we performed electroencephalography (EEG) and magnetic resonance imaging (MRI) of the brain, which revealed an intensified signal on diffusion-weighted imaging (DWI) at the SCC. His mental status improved 5 days after admission, and the SCC lesion had completely disappeared 15 days after admission.
Adult ; Alanine Transaminase/blood ; Corpus Callosum/*radiography ; Creatinine/blood ; Electroencephalography ; Encephalitis/complications/*diagnosis ; Hepatitis A/complications/*diagnosis ; Humans ; Magnetic Resonance Imaging ; Male ; Renal Dialysis

OBJECTIVETo study the clinical features and treatment of serious brainstem encephalitis caused by enterovirus 71 (EV71) infection.

METHODSThe clinical data of 32 hospitalized children with serious brainstem encephalitis caused by EV71 infection between May and December 2008 were retrospectively reviewed.

RESULTSThe children whose age was younger than 3 years old accounted for 88% (22 cases). Fever(>38.5 degrees centigrade)lasting at least 3 days, frequent vomiting and limb twitch were presented as the main manifestations in the 32 children. Cyanosis, tachypnea, tachycardia and cold extremities were observed, and pulmonary edema or even pulmonary hemorrhage occurred in 8 children 3 to 4 days after the onset. The 32 children received a medical treatment: reduction of intracranial pressure with mannitol or frusemide, inhibition of inflammation reactivity with gamma globulin and methylprednisolone, and improvement of cardiac function and pulmonary edema with innotropic agents, fluid restriction and positive mechanical ventilation.

CONCLUSIONSVegetative nerve functional disturbance is the main clinical feature of brainstem encephalitis caused by EV71 infection in children. An early identification and treatment of pulmonary edema or hemorrhage is of great importance.

Brain Stem ; pathology ; Child, Preschool ; Encephalitis, Viral ; complications ; diagnosis ; therapy ; Enterovirus A, Human ; Enterovirus Infections ; complications ; diagnosis ; therapy ; Female ; Humans ; Infant ; Male ; Pulmonary Edema ; etiology ; therapy ; Retrospective Studies

OBJECTIVEThere is no report on Bickerstaff's brainstem encephalitis (BBE) patients in China. We here report the first case of BBE in China.

METHODSClinical features, results of electromyography, electroencephalography (EEG), magnetic resonance imaging (MRI) and cerebrospinal fluid (CSF) examination were studied to clarify the characteristics of this syndrome.

RESULTSA 44-year-old man presented himself at our inpatient department with somnolence and dizziness as his initial symptoms. He developed multiple cranial nerves paralysis especially internal and external ophthalmoplegia, ataxia and tetraparesis within 1 week. His condition rapidly deteriorated, and he experienced coma. Electromyography showed indications of peripheral nerve dysfunction, electroencephalography revealed loss of basic rhythm, MRI demonstrated high-intensity abnormalities on T(2)-weighted images of medulla oblongata, and CSF albuminocytological dissociation was defined abnormally as high protein. Ten months later, he almost completely recovered.

CONCLUSIONBBE, fisher syndrome (FS) and Guillain-Barré syndrome (GBS) are similar clinically; BBE and FS were proposed to be the variant of GBS.

Adult ; Brain ; pathology ; Coma ; Diagnosis, Differential ; Electroencephalography ; Electromyography ; Encephalitis ; complications ; Guillain-Barre Syndrome ; complications ; Humans ; Magnetic Resonance Imaging ; Male ; Medulla Oblongata ; pathology ; Time Factors

Atrophy ; Brain ; pathology ; physiopathology ; Child ; Diagnosis, Differential ; Electroencephalography ; Encephalitis ; complications ; diagnosis ; etiology ; physiopathology ; therapy ; Epilepsia Partialis Continua ; physiopathology ; Humans ; Magnetic Resonance Imaging ; Prognosis

We reported a pediatric case of Kawasaki disease complicated with mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) from Beijing Tsinghua Changgung Hospital. The clinical data were retrospectively analyzed and the related literature was reviewed. The clinical features, treatment and prognosis of the disease were summarized to improve recognition of Kawasaki disease complicated with MERS. A 7-year-old boy was diagnosed with Kawasaki disease due to continuous high fever for 6 d, accompanied by strawberry tongue, conjunctival congestion, erythema-like hyperemia rash, and cervical enlarged lymph nodes. And treatment was started with intravenous immunoglobulin (IVIG: 2 g/kg) and oral aspirin [40 mg/(kg·d)]. Twenty-four hours after the treatment of IVIG, the patient' s fever persisted and in addition he developed headache and drowsiness. His cranial magnetic resonance imaging (MRI) demonstrated a localized lesion in the splenium of the corpus callosum with high intensity signal on diffusion-weighted images (DWI) and T2-weighted, and low intensity signal on apparent diffusion coefficient (ADC) and T1-weighted. Based on these findings, he was diagnosed with MERS-complicated Kawasaki disease. Methylprednisolone [2 mg/(kg·d)] treatment was started intravenously, and within several hours he was afebrile and the neurological symptoms disappeared. A follow-up MRI was conducted after 1 week was normal. He was discharged without any neurological sequelae and coronary artery lesions. A total of 12 qualified foreign literature were retrieved, with no Chinese literature searched. Seventeen children were reported, the median age was 6.5 years (range: 1-14 years), among them 11 cases were children over 5 years old, and 4 cases were complicated with coronary artery lesions. All children had neurological symptoms, such as consciousness disorder, visual hallucination or convulsion. MRI conformed to MERS imaging changes. After active treatment, the neurological manifestations and radiological abnormalities completely disappeared, leaving no neurological sequelae. Kawasaki disease complicated with MERS had not been reported in China by now. Literature that identified Kawasaki disease complicated with MERS mostly occurred in children over 5 years old. Cranial MRI examination is helpful for early diagnosis. Timely treatment can reverse MERS in a short time, without neurological sequelae left.
Brain Diseases/diagnosis* ; Child ; Child, Preschool ; Encephalitis/pathology* ; Fever ; Humans ; Hyperplasia/complications* ; Immunoglobulins, Intravenous/therapeutic use* ; Magnetic Resonance Imaging ; Male ; Mucocutaneous Lymph Node Syndrome/diagnosis* ; Retrospective Studies

OBJECTIVETo study serum ferritin and neuron-specific enolase (NSE) levels in children with hand-foot-mouth disease (HFMD) complicated by acute viral encephalitis and their clinical significance.

METHODSSerum levels of ferritin and NSE were measured using ELISA and electrochemical luminescence in 20 children with HFMD complicated by viral encephalitis (encephalitis group), 20 children with HFMD only (simple HFMD group) and 20 healthy children (control group).

RESULTSSerum levels of ferritin in the encephalitis group (212 ± 71 μg/L) were significantly higher than in the simple HFMD group (85 ± 18 μg/L) and control group (70 ± 15 μg/L) (P<0.01). Serum levels of NSE in the encephalitis group (8.6 ± 2.6 μg/L) were also significantly higher than in the simple HFMD group (6.0 ± 1.3 μg/L) and control group (5.6 ± 1.8 μg/L) (P<0.01). Significantly decreased serum ferritin (126 ± 37 μg/L) and NSE levels (6.8 ± 1.9 μg/L) were found in the encephalitis group (P<0.01) after treatment.

CONCLUSIONSSerum levels of ferritin and NSE in children with HFMD complicated by acute viral encephalitis increase, suggesting that serum ferritin and NSE measurement is useful in the early diagnosis of HFMD complicated by acute viral encephalitis.

Acute Disease ; Child, Preschool ; Encephalitis, Viral ; blood ; Female ; Ferritins ; blood ; Hand, Foot and Mouth Disease ; blood ; complications ; diagnosis ; Humans ; Male ; Phosphopyruvate Hydratase ; blood