Course and outcome of acute cerebellar ataxia

Connolly, Anne M.; Dodson, W. Edwin; Prensky, Arthur L.; Rust, Robert S.

doi:10.1002/ana.410350607

Cited by 205 publications

(166 citation statements)

References 13 publications

Supporting

Mentioning

142

Contrasting

Unclassified

Order By: Relevance

“…19,20 Intrathecal OCBs were also found in patients with Rasmussen encephalitis and acute cerebellar ataxia, as previously reported. 21,22 Although OCBs can be useful, we failed to detect OCBs in many patients with recognized inflammatory CNS diseases. The absence of OCBs should not preclude consideration of an inflammatory CNS process, or testing for specific autoantibodies.…”

Section: Discussionmentioning

confidence: 92%

Clinical association of intrathecal and mirrored oligoclonal bands in paediatric neurology

Sinclair

Wienholt

Tantsis

et al. 2012

Develop Med Child Neuro

View full text Add to dashboard Cite

ABBREVIATIONS ADEMAcute disseminated encephalomyelitis CSF Cerebrospinal fluid HSV Herpes simplex virus NMDAR N-methyl-D-aspartate receptor OCB Oligoclonal band VGKC Voltage-gated potassium channel AIM Biomarkers such as autoantibodies, neopterin, and oligoclonal bands (OCBs) are increasingly used for the diagnosis of treatable inflammatory central nervous system (CNS) disorders. We investigated the correlation between the results of OCB testing and clinical diagnoses in a large contemporary cohort of children with a broad range of neurological conditions.METHOD Cerebrospinal fluid (CSF) and serum from 200 children (94 females, 106 males; age range 2mo-15y 10mo, mean age 6y 9mo, SD ±4.9) who underwent CSF investigation for their neurological condition were tested for OCBs using isoelectric focusing. RESULTSThe patients were divided into those with inflammatory (n=58) and non-inflammatory There is increasing interest in biomarkers that diagnose potentially treatable inflammatory central nervous system (CNS) disorders. 1 Some serum and cerebrospinal fluid (CSF) autoantibodies are specific biomarkers associated with autoimmune syndromes such as N-methyl-D-aspartate receptor (NMDAR) encephalitis and voltage-gated potassium channel (VGKC) encephalopathy. Other biomarkers, including CSF neopterin and oligoclonal bands (OCBs), are less specific, but they are still useful markers of immune activation or inflammation in the CNS.2 Before the discovery of the NMDAR antibody biomarker, OCBs were used to support the hypothesis that encephalitis lethargica and immunemediated chorea encephalopathy syndrome were autoimmune diseases; these syndromes have subsequently been shown to be NMDAR encephalitis. [3][4][5] OCBs have also been useful in the identification of unusual variants of known autoimmune encephalopathy. 6OCBs are clones of immunoglobulin (typically IgG) that can be detected in the CSF and ⁄ or serum. The qualitative method of isoelectric focusing on agarose gels followed by immunoblotting is the accepted standard method for OCB detection. The IgG index (the ratio of CSF ⁄ serum IgG to CSF ⁄ serum albumin), a quantitative method of analysis, is a less sensitive test, and when elevated is suggestive of a CNS B-cell response. There are limited reports of use of the IgG index in paediatric studies, but in adult studies the IgG index has been found to be only rarely elevated in patients with multiple sclerosis who have negative OCBs. [7][8][9][10][11]7 in a paediatric cohort, found that the IgG index was less frequently elevated in those with acute disseminated encephalo- When OCBs are present in the CSF and absent from the serum, this is termed an 'intrathecal pattern' and is indicative of local antibody production and hence a humoral immune response within the CNS. When identical clones of IgG are present in the CSF and serum, this is termed a 'mirrored pattern' and suggests that IgG has entered the CNS from the systemic circulation, such as occurs in blood-brain barrier damage.A combination of mirrored and intrathecal...

show abstract

Section: Discussionmentioning

confidence: 92%

Clinical association of intrathecal and mirrored oligoclonal bands in paediatric neurology

Sinclair

Wienholt

Tantsis

et al. 2012

Develop Med Child Neuro

View full text Add to dashboard Cite

show abstract

“…Nevertheless, in some cases like our and cases from literature, it remains totally normal [9,11]. MRI low sensibility could explain normal or very inconspicuous images in cerebellitis [14,15]. In addition to that, MRI features should be critically related to time of its applying as some authors described delayed MRI abnormalities.…”

Section: Discussionmentioning

confidence: 99%

Acute Cerebellitis Associated with Influenza A(H1N1)pdm09 Virus in a Child, Tunisia, 2016

Gdoura¹

2017

CSMC

View full text Add to dashboard Cite

“…Other CNS complications associated with VZV infection include post-varicella cerebellitis, meningoencephalitis (including the Ramsay Hunt syndrome), vasculopathy, and acute aseptic meningitis. 4,41,51,73 In people with HIV infection, CNS complications of VZV infection, most notably herpes zoster, occur more frequently than in the general population. 130…”

Section: Herpesvirus Familymentioning

confidence: 99%

Central Nervous System Infection During Immunosuppression

Zunt

2002

Neurologic Clinics

View full text Add to dashboard Cite

The central nervous system (CNS) is susceptible to bacterial, viral, and fungal infections. Suppression of the immune system by human immunodeficiency virus (HIV) infection or immunosuppressive therapy after transplantation increases susceptibility to CNS infection and modifies the presentation, diagnosis, and recommended treatment of various CNS infections. This chapter discusses how suppression of the host immune status modifies the presentation, diagnosis, and treatment of selected CNS infections. IMMUNOSUPPRESSION ASSOCIATED WITH HIV INFECTIONNeurologic illness occurs in 40% to 60% of HIV-infected people. 87 Infection of the CNS may occur during any stage of HIV infection, but opportunistic infection occurs only during latestage infection, when the CD 4 count falls below 200 cells/dL. 114 Opportunistic infection may affect the brain or spinal cord, and onset may be acute, subacute, or chronic. The most common opportunistic CNS infections and neoplasms are: Toxoplasma encephalitis (TE), cryptococcal meningitis, primary CNS lymphoma (PCNSL), progressive multifocal leukoencephalopathy (PML), AIDS dementia complex (ADC, also known as HIV-associated dementia), and cytomegalovirus (CMV) encephalitis. 10 Focal brain lesions occur in up to 17% of people with AIDS and are most often caused by TE, PML, or PCNSL. 6 Since the introduction of potent antiretroviral therapy (previously called highly active antiretroviral therapy, or HAART), the incidence of TE and PCNSL has decreased, whereas the incidence of PML has increased. 5, 21, 98, 107 IMMUNOSUPPRESSION ASSOCIATED WITH TRANSPLANTATIONNeurologic complications occur in 30% to 60% of people receiving solid organ transplantation and in 12% to 70% of people receiving bone marrow transplantation (BMT). Complications include infection of the CNS, encephalopathy, seizure, stroke, and peripheral neuropathy. 47, 61, 109 Infection of the CNS occurs in 5% to 10% of transplant patients and most often manifests as brain abscess, encephalitis, or meningitis. 42 Aspergillus fumigatus, Listeria monocytogenes, and Cryptococcus neoformans are the most common causes of CNS infections in post-transplant patients.Immunosuppressive therapy reduces cell-mediated immunity to prevent rejection of transplant and graft versus host disease (GVHD), but this immunosuppression increases risk of infection by fungi, viruses (especially herpesviruses), bacteria, and parasites. In addition, some immunosuppressive agents, notably cyclosporine and tacrolimus Susceptibility to CNS infection after transplantation changes over time. 42, 109 During the initial month, CNS infection is most often caused by common bacterial pathogens or opportunistic pathogens present in either the transplant environment (e.g., Aspergillus species), or host (e.g., Mycobacterium tuberculosis). At 1 to 6 months, immunosuppression is at its highest, resulting in increased susceptibility to CNS infection by the herpesviruses, especially CMV and Epstein-Barr virus (EBV), fungi, and atypical bacteria. Finally, after 6 month...

show abstract

Course and outcome of acute cerebellar ataxia

Cited by 205 publications

References 13 publications

Clinical association of intrathecal and mirrored oligoclonal bands in paediatric neurology

Clinical association of intrathecal and mirrored oligoclonal bands in paediatric neurology

Acute Cerebellitis Associated with Influenza A(H1N1)pdm09 Virus in a Child, Tunisia, 2016

Central Nervous System Infection During Immunosuppression

Contact Info

Product

Resources

About