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Arthropod-borne virus encephalitis
Published in Avindra Nath, Joseph R. Berger, Clinical Neurovirology, 2020
La Crosse virus is at once the most common cause of endemic encephalitis in children in the U.S., and the most frequently identified arbovirus encephalitis in the U.S. An average of 74 cases were reported annually from 1964 to 1999 in the U.S. [13]. A member of the California serogroup bunyaviruses of the Bunyaviridae family, La Crosse is a single stranded RNA virus with a negative sense genome of three segments [72]. First isolated from the brain of a four-year-old girl in La Crosse, Wisconsin in 1960 [73], it was not the first virus in the serogroup to be isolated. California encephalitis virus was first isolated from mosquitoes in Kern County at the southern end of the San Joaquin Valley in California in 1943 [74]. It was associated with three cases of encephalitis two years later, but no further cases were reported until that of a 65-year-old man who fully recovered from encephalitis in Marin County, California in 1996 [75]. In contrast, another member of the California serogroup, Jamestown Canyon Virus, appears to be significantly more common than previously appreciated. Mayo and his colleagues have recently found seroprevalence rates between 3.9% and 10.1% in Connecticut, citing similar prevalence rates in Massachusetts [76].
Human Metapneumovirus Infections
Published in Sunit K. Singh, Human Respiratory Viral Infections, 2014
Jennifer Elana Schuster, John V. Williams
MPV has been infrequently linked to encephalitis. MPV has been isolated from cerebrospinal fluid (CSF) once in the literature: a 10-year-old female with respiratory symptoms and altered mental status. The patient had a CSF pleocytosis, and MPV was isolated from both CSF and NP specimens. Imaging demonstrated multiple T2 hyperintense lesions consistent with encephalitis and an associated demyelinating process.55 Another case report documents a 6-month-old female with fever, respiratory symptoms, and seizures. Computed tomography (CT) scan demonstrated low-density white matter areas, and the child ultimately died. MPV, the only pathogen isolated, was identified by polymerase chain reaction (PCR) from urine and throat specimens.56 Similarly, a 14-month-old boy with fever and respiratory symptoms developed altered mental status and seizures. He developed increased intracranial pressure and subsequently died. Brain and lung tissue specimens were positive for MPV by PCR; no other infectious etiology was identified. Similar to previous case reports, imaging demonstrated multifocal lesions.57 The California Encephalitis Project identified five children with encephalitis and positive NP swabs for MPV. Imaging findings included white matter changes on magnetic resonance imaging (MRI).58
Bunyaviruses
Published in Sunit K. Singh, Daniel Růžek, Neuroviral Infections, 2013
Patrik Kilian, Vlasta Danielová, Daniel Růžek
The California encephalitis virus is the prototype member of this serogroup. The virus was isolated in 1941 and is thought to be a cause of human encephalitis in California (Hammon and Reeves 1952). Later, it was discovered that the LACV, isolated from the brain of a 4-year-old girl in 1964 (Thompson et al. 1965), is responsible for severe disease, predominantly in children younger than 16 years of age, and that it appears more frequently. The incidence of LACY infection can be up to 20-30 cases per 100,000 inhabitants in endemic areas.
Anti-N-methyl-D-aspartate receptor antibody encephalitis: An important cause of encephalitis in young adults. A report of two cases
Published in Journal of American College Health, 2019
Anti-NMDAR encephalitis was first described by Dalmau et al in 2007.1 In one case series, The California Encephalitis Project, it surpassed the incidence of any viral cause of encephalitis for which a clear diagnosis could be established.2 Indeed, anti-NMDAR encephalitis was diagnosed with a frequency more than four times that for HSV-1-, West Nile Virus- or VZV-associated encephalitis.2 A feature which can sometimes distinguish anti-NMDAR encephalitis from other causes is the relative prominence of psychiatric symptoms. These can include hallucinations, bizarre behavior, panic attacks, marked personality changes, catatonia-like states, aggression, and amnesia.2 Seizures are common.2 As anti-NMDAR encephalitis is a para-neoplastic syndrome, the evaluation of patients suspected of having it generally must include a thoughtful search for an underlying tumor; in women, often a teratoma.
Immunopsychiatry: an update on autoimmune encephalitis for neuropsychiatrists
Published in Expert Review of Neurotherapeutics, 2022
Frederico Moraes Cardoso Marques, Antônio Egídio Nardi, Antonio L. Teixeira, Leonardo Caixeta
A hospital-based multicenter and prospective study from the United Kingdom showed that the rate of encephalitis that remains without an etiological diagnosis is high, between 40% and 50% of cases. AIE was considered the third most common cause of encephalitis after viral encephalitis and acute demyelinating encephalomyelitis (ADEM). The most common type of AIE was anti-NMDAR encephalitis [3]. Partly corroborating these findings, a prospective cohort study from the California Encephalitis Project reported that incidence of anti-NMDAR encephalitis is greater than that of herpes simplex encephalitis [12].
Treatment Options for Anti-N-methyl-D-aspartate Receptor Encephalitis
Published in The Neurodiagnostic Journal, 2018
In 2005, a wide range of symptoms including psychotic disturbances, memory loss, hypoventilation, altered consciousness, and dyskinesia (movement disorder) were reported in 4 women with ovarian teratomas (Vitaliani et al. 2005). The California encephalitis project was conducted to identify the unclear cause of this condition and on the possibility of any particular viral cause of this disease (Gable et al. 2012). In 2007, Dalmau et al. identified autoantibodies specific to the N-methyl-d-aspartate receptor (NMDAR) in these patients and other patients with this condition and concluded that a large quantity of antibodies targeted NMDARs in the hippocampal region of the brain (Dalmau et al. 2007). Anti-NMDAR encephalitis was classified within the limbic system encephalitides; which is an autoimmune noncontagious inflammatory disease of the central nervous system (Mann et al. 2014). In Charles Lemoyne Hospital, the complexity of treatment for anti-NMDAR encephalitis requires numerous follow-up appointments and the implementation of a multidisciplinary team that includes nurses, neurologists, radiologists, and neurodiagnostic technologists. The objectives of care in Charles-LeMoyne Hospital are to optimize recovery and prevent relapses. Although the prognosis of this autoimmune encephalitis remains quite variable, when the diagnosis is made in the early stages by the neurology team at Charles-LeMoyne center, most patients show progressive neurological improvement toward full recovery. The recovery process is established over prolonged period of several months or even years. Countless patients will never have the opportunity for recovery due to the diverse complications that may occur during hospitalization or rehabilitation (Dalmau et al. 2011). However, in 2012, New York Post journalist Susannah Cahalan wrote a book on her experience with and recovery from this disease (Cahalan 2012). This famous case of NMDAR encephalitis is evidence that this neurological disorder can be reversible, and her story inspired me to write this article.