A 73-year-old man was admitted to our hospital with disturbance of consciousness, fever and headache. Cerebrospinal fluid (CSF) analysis revealed pleocytosis with neutrophil predominance, increased protein and low glucose. CSF and blood cultures yielded negative results. Antibiotics and antituberculous drugs were started for meningitis. An antimycotic was also added. The patient died from trans...

A 45-year-old man presented with progressive Broca aphasia and right hemiparesis. MRI demonstrated a large white matter lesion with multiple rings (figure). These centrifugal rings reflect concentric layers of active demyelination, typical for Baló concentric sclerosis. CSF showed oligoclonal bands and a mild pleocytosis. Partial recovery followed 5 days of treatment with IV methylprednisolone ...

A 32-year-old female with depression on treatment, was presented with acute psychosis, behavioural symptoms, autonomic instability and a prodromal illness. This occurred on a background of a strong family history of schizophrenia. Despite escalating doses of anti-psychotics, she failed to improve. Her CSF showed a lymphocytic pleocytosis and confirmed the presence of anti-NMDAR antibodies. Foll...

BACKGROUND Anti N-methyl-D-aspartate (NMDA) receptor encephalitis is an immune mediated disorder. CASE CHARACTERISTICS A previously healthy 14-year-old girl presenting with generalized tonic clonic seizures and altered behavior. OBSERVATION In view of refractory seizures, hallucinations, psychobehavioral and catalepsy like symptoms, and CSF showing lymphocytic pleocytosis, possibility of au...

The meningopolyneuritis first described in 1922 by Garin and Bujadoux develops after a tick bite. At the site of the bite in some of the cases, erythema chronicum migrans develops first. Severe pains follow in this area which may spread to other parts of the body. Then peripheral paralysis appears with asymmetrical distribution. The motor cerebral nerves, especially the facial nerve, are also f...

Ocular complications of HIV-related cryptococcal meningitis are reasonably common, but complete binocular blindness as the first manifestation of HIV is extremely rare. A 58-year-old man presented with binocular blindness. He experienced blurred vision for 3 days before the blindness. Mild pleocytosis was present in the cerebrospinal fluid, from which Cryptococcus neoformans was cultured. Serol...

Neurobrucellosis manifesting as optic neuritis is a rare disease in childhood. We report a case of neurobrucellosis in a 11 year old girl leading to visual impairment and headache. Physical examination revealed mild oedema of right tibiotarsic joint and optic neuritis. Investigations showed CSF pleocytosis and a Brucella serum agglutination titer of 1/640. Complete reversal of the symptoms was ...

To elucidate immunopathogenetic roles of aquaporin-4 antibodies in the cerebrospinal fluid (CSF) of neuromyelitis optica spectrum disorders (NMOSD), we analyzed aquaporin-4 antibody titers, cellular and inflammatory markers in the CSF collected from 11 aquaporin-4 antibody seropositive patients. The CSF aquaporin-4 antibody levels during attacks (but not in sera) closely correlated with pleocyt...

Unlike bacterial and fungal meningitis in which imaging abnormalities are not specific for a particular agent, many virus infections of the CNS produce MRI abnormalities not seen by any other infectious agent. The changes caused by the specific virus can also be produced by noninfectious disorders. Imaging changes must always be evaluated in conjunction with the clinical symptoms, signs, and la...

Varicella zoster virus reactivation is a rare cause of pharyngeal dysphagia with long-term sequelae persisting in most cases. A 76-year-old immunocompetent woman presented with a 4-week history of dysphagia and dysphonia. Brain magnetic resonance imaging displayed a negative finding. Fiberoptic endoscopic evaluation of swallowing showed a severe dysphagia leading to a percutaneous gastrostomy e...