Oligoclonal banding in the cerebrospinal fluid of patients with postencephalitic Parkinsonism.

Woman with a 26‐year history of parkinsonism, supranuclear ophthalmoplegia, and loss of postural reflexes

“…Western equine encephalitis and other encephalitides can also produce a chronic parkinsonian state, occasionally with delayed progression. 14,22 Most of the non-von Economo's cases did not have the oculogyric crises, dystonia, personality changes, or L-dopa responsiveness that occurred in most post-von-Economo's patients but not in ours.…”

“…14 Like PSP, PEP is a disorder of tau deposition without amyloid deposition. It can be confused with PSP pathologically and can assume a myriad of clinical pictures, most of which include rigidity and bradykinesia and some of which include limitation of vertical gaze.…”

Viruses, Immunity, and Mental Disorders

“…Pathological examination of the brains of the four fatal cases revealed a severe inflammatory process in the substantia nigra with proliferation of phagocytic cells and abundant plasma cells and lymphocytes. Williams et al (1979) have reported two sporadic cases of progressive parkinsonism after an unidentified encephalitis; both patients had oligoclonal protein bands in their CSF, a finding not noted in six cases of idiopathic Parkinson's similarly studied; serum and CSF antibody titers to several conventional viruses were nonnal. recognized six cases, between 1961 and 1981, of "a fonn of parkinsonism with clinical features similar to those recorded during the pandemic of encephalitis lethargica"; they comment on the possibility of a viral etiology being involved.…”

“…Rare cases of sporadic, acute, often transitory, occasionally progressive parkinsonian syndromes temporally associated with encephalitides other than von Economo's encephalitis continue to occur and have been reported for lymphocytic choriomeningitis (LCM) (Adair et ai., 1953), group B coxsackieviruses (Walters, 1960;Poser et al, 1969), Japanese B encephalitis (Goto, 1962;Shiraki et al, 1963), Western equine encephalitis (WEE) (Mulder et al, 1951;Herzon et al, 1957), group B tick-borne encephalitis (Henner and Hanzal, 1963;Seitelberger and Jellinger, 1966), influenza A (Isgreen et al, 1976), and other unidentified, presumably viral, agents (Bojinov, 1971;Herishann and Noah, 1973;Miyasaki and Fujita, 1977;Williams et al, 1979;Lang et al, 1982).…”

Emergence of A New Entity: The Autoimmune Encephalitis

“…Encephalitis can also occur as an immune-mediated phenomenon-for example, acute disseminated encephalomyelitis (ADEM), which follows infections or vaccinations and paraneoplastic limbic encephalitis (PLE) associated with specific autoantibodies in patients with tumours.. However, the finding of CSF oligoclonal bands (OCB) 16,17,18 and the successful treatment of some recent cases with steroids 5 had led investigators to propose that there may be an immune-mediated type of encephalitis also.…”