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14 Cards in this Set
- Front
- Back
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What is Bickerstaff encephalitis |
GBS variant with ophthalmoplegia, ataxia, encephalopathy, associated with peripheral motor axonal demyelination with brainstem encephalitis |
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What is ADEM? |
acute disseminated encephalomyelitis, a disease of multifocal white matter demyelination |
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How does ADEM usually present? |
Rapid onset of progressive encephalopathy associated with multifocal neurologic deficits |
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MRI findings in ADEM |
Typically large, multiple, asymmetric lesions involving subcortical and central white matter, located at gray-white junction in hemispheres, cerebellum, brainstem |
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Difference in MRI findings in ADEM vs MS |
Deep gray matter can be involved in ADEM, esp caudate, globes pallidus, putamen, thalamus |
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Treatment of choice for ADEM |
IV methylprednisolone 1g/day x 3-5 days |
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ADEM stepwise treatment |
Methylprednisolone IVIG Plasmapheresis |
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Dose for IVIG |
0.4/kg/day x 5 days |
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How does IVIG work in ADEM? |
Not fully understood, block Fc-receptor on macrophage and decreases cell-mediated immune response |
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How does plasmapheresis work in ADEM? |
Removes humoral factors and affects balance of B cells and T helper type 1 and type 2 cells. |
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Hallmark of ADEM on biopsy |
Perivenous demyelination as opposed to confluent demyelination in MS |
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Tumor associated with NMDAR antibody |
Teratoma |
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Antibody associated with lung cancer |
AMPAR Hi for SCLC |
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Most effective treatment of NMDAR encephalitis |
identification and removal of the teratoma |
