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Introduction: There is a complex interplay between systemic autoimmunity, immunosuppression, and infections. Any or all of these can result in neurologic manifestations, requiring diligence on the part of neurologists.
Case Report: We herein report a case of a patient on immunosuppressive treatment for a vasculitis that resulted in zoster meningoencephalitis. This was further complicated by the development of anti-NMDAr encephalitis, the etiology of which is undetermined and further discussed in this paper. The patient eventually developed COVID-19 during hospitalization, succumbing to the respiratory infection.
Conclusion: This case emphasizes that post-infectious autoimmune disorders are becoming increasingly recognized and that they should still be considered in patients who are on immunosuppression. Practitioners should be aware of the complex relationship between autoimmunity and immunosuppression and consider both throughout the disease course.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8977756 | PMC |
http://dx.doi.org/10.1177/19418744211063709 | DOI Listing |
Pediatr Neurol
August 2025
Division of Pediatric Neurology and Developmental Neuroscience, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas; Center for Human Immunobiology, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas. Elec
Background: Pediatric N-methyl-d-aspartate receptor (NMDAR) encephalitis (pNMDARE) is characterized by severe neuropsychiatric symptoms and prolonged hospitalization and recovery. Early pNMDARE diagnosis is complicated by neuropsychiatric mimickers requiring strong clinical suspicion to escalate to the required lumbar puncture (LP), delaying diagnosis and treatment. Since autonomic dysfunction is a cardinal feature of pNMDARE, we hypothesized that early vital signs serve as a potential noninvasive biomarker to screen for appropriate escalation of pNMDARE evaluation.
View Article and Find Full Text PDFNeurol Sci
September 2025
Department of Neurology, JIPMER, 605006, Puducherry, India.
J Craniofac Surg
September 2025
Department of Neurosurgery, The Sixth Affiliated Hospital, School of Medicine, South China University of Technology, Foshan, Guangdong, China.
This case report highlights a rare association between anti-NMDAR encephalitis and meningioma, where the patient developed typical autoimmune encephalitis symptoms shortly after tumor resection. Unlike the well-established link with ovarian teratomas, meningioma-associated cases may involve indirect immune mechanisms, such as molecular mimicry or bystander activation, rather than direct antigen exposure. The findings emphasize the need for postoperative autoimmune screening in neurosurgical patients with unexplained neuropsychiatric symptoms.
View Article and Find Full Text PDFQuant Imaging Med Surg
September 2025
Department of Neurology, The First Affiliated Hospital of Dalian Medical University, Dalian, China.
Background: Imaging, particularly multimodal magnetic resonance imaging (MRI), serves as an essential auxiliary examination for diagnosing autoimmune encephalitis (AE). The diversity of autoantibodies complicates the imaging presentation of AE, exhibiting both common and individual features across different subtypes of AE. Currently, there is a lack of comprehensive studies on the imaging features of different subtypes of AE.
View Article and Find Full Text PDFBMC Neurol
August 2025
Department of Clinical Pediatrics Sciences, Unit of Child Neuropsychiatry, Member of the ERN Epicare Network, IRCCS Istituto Giannina Gaslini, Via G Gaslini 5, Genova, 16100, Italy.
Background: Herpes simplex virus 1 (HSV-1) encephalitis may result in relapsing neurological symptoms secondary to immune-mediated processes, including anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. Refractory status dyskineticus (RSD), a severe subset of status dystonicus, is characterized by a hyperkinetic movement disorder phenotype alongside dystonic features. This critical condition presents substantial challenges in neurocritical care.
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