Wang M.-L.a· Liu R.b· Zhang L.-M.a· Zhao B.a· Jia R.a· Zhao Y.a· Xi Y.-L.a· Ma J.-X.a· Ma H.a

Author affiliations

aDepartment of Neurology, Binzhou Medical University Hospital, Binzhou, China
bDepartment of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China

Log in to MyKarger to check if you already have access to this content.

Buy FullText & PDF Unlimited re-access via MyKarger Unrestricted printing, no saving restrictions for personal use read more

CHF 38.00 *
EUR 35.00 *
USD 39.00 *

Select

KAB

Buy a Karger Article Bundle (KAB) and profit from a discount!

If you would like to redeem your KAB credit, please log in.

Save over 20% compared to the individual article price.

Learn more

Access via DeepDyve Unlimited fulltext viewing of this article Organize, annotate and mark up articles Printing and downloading restrictions apply

Select

Subscribe Access to all articles of the subscribed year(s) guaranteed for 5 years Unlimited re-access via Subscriber Login or MyKarger Unrestricted printing, no saving restrictions for personal use read more

Subcription rates

Select

* The final prices may differ from the prices shown due to specifics of VAT rules.

Article / Publication Details

First-Page Preview

Received: November 02, 2021
Accepted: May 06, 2022
Published online: June 27, 2022

Number of Print Pages: 8
Number of Figures: 4
Number of Tables: 1

ISSN: 1021-7401 (Print)
eISSN: 1423-0216 (Online)

For additional information: https://www.karger.com/NIM

Abstract

Purpose: We report two cases diagnosed as acute necrotizing encephalopathy (ANE) with acute onset and various clinical manifestations. Methods: The patients’ data were obtained from the medical records of the Binzhou Medical University Hospital in Binzhou, China. The clinical symptoms, laboratory examination, neuroimaging, treatment, and prognosis of the 2 patients were collected and analyzed. Results: We report 2 adult ANE patients with acute onset. The first symptom was fever, followed by symptoms and signs of damage to the central nervous system. The patients were infected with herpes simplex virus and influenza virus, respectively. The main manifestation on brain magnetic resonance imaging was a mixed-signal of a “three-layer structure” in the bilateral thalamus. The first patient died. Based on the experience of the diagnosis and treatment of the first patient, combined with a review of the literature, the second patient was immediately treated with glucocorticoid pulse therapy combined with gamma globulin injection. This patient’s condition was controlled, and the prognosis was good. Conclusions: This study describes the clinical symptoms, laboratory examination, neuroimaging evidence, and treatment experience of ANE in adults. We believe that the progress of the disease may be controlled, and the prognosis may be improved if glucocorticoid pulse therapy combined with gamma globulin injection is used as soon as possible.

© 2022 S. Karger AG, Basel

References Mizuguchi M. Acute necrotizing encephalopathy of childhood: a novel form of acute encephalopathy prevalent in Japan and Taiwan. Brain Dev. 1997 Mar;19(2):81–92. Zhu HM, Liu ZS. Advances in clinical and imaging studies of acute necrotizing encephalopathy. Zhonghua Er Ke Za Zhi. 2017 Nov;55(11):865–8. Goo HW, Choi CG, Yoon CH, Ko TS. Acute necrotizing encephalopathy: diffusion MR imaging and localized proton MR spectroscopic findings in two infants. Korean J Radiol. 2003 Jan–Mar;4(1):61–5. Oki J, Yoshida H, Tokumitsu A, Takahashi S, Miyamoto A, Yoda M, et al. Serial neuroimages of acute necrotizing encephalopathy associated with human herpesvirus 6 infection. Brain Dev. 1995 Sep–Oct;17(5):356–9. Narra R, Mandapalli A, Kamaraju SK. Acute necrotizing encephalopathy in an adult. J Clin Imaging Sci. 2015 Apr;5:20. Lee YJ, Hwang SK, Lee SM, Kwon S. Familial acute necrotizing encephalopathy with RANBP2 mutation: the first report in Northeast Asia. Brain Dev. 2017 Aug;39(7):625–8. Modi S, Mahajan A, Dharaiya D, Varelas P, Mitsias P. Burden of herpes simplex virus encephalitis in the United States. J Neurol. 2017 Jun;264(6):1204–8. Preziosa P, Moiola L, Baldoli C, Longo D, Sangalli F, Radaelli M, et al. Necrotic-hemorrhagic myelitis: a rare malignant variant of parainfectious acute disseminated encephalomyelitis in childhood. J Neurol Sci. 2018 Jan;384:58–60. Aung WY, Massoumzadeh P, Najmi S, Salter A, Heaps J, Benzinger TLS, et al. Diffusion tensor imaging as a biomarker to differentiate acute disseminated encephalomyelitis from multiple sclerosis at first demyelination. Pediatr Neurol. 2018 Jan;78:70–4. Moftakhar P, Danielpour M, Maya M, Alexander MJ. Spontaneous thrombosis of neonatal vein of Galen malformation. Neurosurg Focus. 2009 Nov;27(5):E12. Li X, Qi S, Jiao Y, Gao J, Du H. A case report of primary central nervous system lymphoma with intestinal obstruction as the initial symptom. Medicine. 2018 Mar;97(10):e0080. Wu X, Wu W, Pan W, Wu L, Liu K, Zhang HL. Acute necrotizing encephalopathy: an underrecognized clinicoradiologic disorder. Mediators Inflamm. 2015;2015:792578. Vargas WS, Merchant S, Solomon G. Favorable outcomes in acute necrotizing encephalopathy in a child treated with hypothermia. Pediatr Neurol. 2012 Jun;46(6):387–9. Suwa K, Yamagata T, Momoi MY, Kawakami A, Kikuchi Y, Miyao M, et al. Acute relapsing encephalopathy mimicking acute necrotizing encephalopathy in a 4-year-old boy. Brain Dev. 1999 Dec;21(8):554–8. Article / Publication Details

First-Page Preview

Received: November 02, 2021
Accepted: May 06, 2022
Published online: June 27, 2022

Number of Print Pages: 8
Number of Figures: 4
Number of Tables: 1

ISSN: 1021-7401 (Print)
eISSN: 1423-0216 (Online)

For additional information: https://www.karger.com/NIM

Copyright / Drug Dosage / Disclaimer Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.