| Autor: |
Vallabhaneni D; Department of Internal Medicine, SUNY Upstate Medical University, Syracuse, NY, USA., Naveed MA; Department of Radiology, Shaukat Khanum Memorial Cancer Hospital, Lahore, Pakistan.; Department of Radiology, SUNY Upstate Medical University, Syracuse, NY 13210, USA., Mangla R; Department of Radiology, SUNY Upstate Medical University, Syracuse, NY 13210, USA., Zidan A; Department of Neurology, SUNY Upstate Medical University, Syracuse, NY, USA., Mehta RI; Department of Radiology, SUNY Upstate Medical University, Syracuse, NY 13210, USA.; Department of Radiology, West Virginia University, Morgantown, WV, USA. |
| Abstrakt: |
Encephalitis is characterized by inflammation of brain tissue and has various infectious and noninfectious causes. CSF analysis and MRI usually reveal inflammatory changes although sometimes brain imaging may be normal. Autoimmune encephalitis is caused by antibodies against neuronal synaptic receptors, surface proteins, or intracellular proteins. In this case report, we present a 65-year-old female who presented with a fall and altered mental status. Workup for infectious etiologies was negative and MRI of the brain displayed focal restricted diffusion with corresponding T2-FLAIR hyperintensity involving gray matter structures, making the diagnosis unclear. CT perfusion of the brain demonstrated increased cerebral blood volume and cerebral blood flow in the left parietooccipital gray matter, with corresponding normal mean transit time. Following treatment failure with acyclovir, antibiotics, and steroids, the patient was found to be positive for GAD65 antibodies and diagnosed with autoimmune encephalitis. Symptoms markedly improved with plasmapheresis. Autoimmune encephalitis rarely causes restricted diffusion and this is the first case report to describe corresponding hyperperfusion on CT perfusion study. |
