Subacute rhombencephalitis optica responsive to intravenous immunoglobulins.
A 53-year-old man presented with optic neuritis, followed within 10 weeks by a subacute progression of weakness, ataxia, and multiple cranial nerve palsies. Cranial magnetic resonance imaging demonstrated multiple T2-hyperintense lesions extending from the ponto-medullary junction to the thalamus and internal capsule. Cerebrospinal fluid analysis showed lymphocytic pleocytosis with elevated protein content. A brain biopsy revealed inflammatory changes. After a month long period of inexorable worsening, the patient was treated with intravenous immunoglobulins (2 g/kg). He responded to treatment, and recovered over the subsequent 3 months. The patient's response to treatment suggests that intravenous immunoglobulins should be considered in patients with inflammatory brain disorders.
Zivković
S A
SA
Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Heyman
R
R
Pless
M
M
D004660:Encephalitis / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D005911:Gliosis / Q000276:immunology / Q000473:pathology; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012249:Rhombencephalon / Q000276:immunology / Q000473:pathology*
D016756:Immunoglobulins, Intravenous