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Abstract

Background: Autoimmune inflammatory encephalitis is an inflammation of the brain characterized by prominent neuropsychiatric symptoms and are associated with antibodies against neuronal cell-surface proteins, ion channels, or receptors. Most common causes of autoimmune encephalitis include Anti-NMDA antibodies, paraneoplastic syndromes, and in rare cases, seroconversion from an HSV infection. This report discusses a rare case of autoimmune encephalitis after a head trauma obtained from a ground level fall.

Case Presentation: Patient was a 55-year-old Hispanic man who presented to the emergency department with worsening confusion. Two months prior, the patient presented to an urgent care with a head laceration after a ground level fall at work. After admission, radiologic findings revealed encephalitis evident by temporal lobe enhancement on MRI. Laboratory and cerebrospinal fluid findings were negative for reasonable causes of encephalitis like Infection, tumor, and metabolic syndromes. Pharmacologic intervention began with the use of methylprednisolone and IVIG for 5 days. Patient saw significant improvement in functional, neurologic, and cognitive status with complete resolution of previously noted enhancement within the left temporal and left occipital lobe.

Conclusion: Autoimmune encephalitis is largely a diagnosis of exclusion. Diagnostic criteria include neuropsychiatric symptoms, nervous system deficits, seizures, and exclusion of reasonable cause. In the absence of an obvious cause and clinical improvement upon treatment with methylprednisolone, it was safe to assume Autoimmune Encephalitis with an unknown etiology or likely triggered by previous head trauma. This case report implies the need for focus on research exploring autoimmune encephalitis secondary to previous head trauma.

Presentation Type

Poster

Academic Level

Medical Student

Mentor/PI Department

Internal Medicine

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A Case Report on Autoimmune Encephalitis after Head Trauma

Background: Autoimmune inflammatory encephalitis is an inflammation of the brain characterized by prominent neuropsychiatric symptoms and are associated with antibodies against neuronal cell-surface proteins, ion channels, or receptors. Most common causes of autoimmune encephalitis include Anti-NMDA antibodies, paraneoplastic syndromes, and in rare cases, seroconversion from an HSV infection. This report discusses a rare case of autoimmune encephalitis after a head trauma obtained from a ground level fall.

Case Presentation: Patient was a 55-year-old Hispanic man who presented to the emergency department with worsening confusion. Two months prior, the patient presented to an urgent care with a head laceration after a ground level fall at work. After admission, radiologic findings revealed encephalitis evident by temporal lobe enhancement on MRI. Laboratory and cerebrospinal fluid findings were negative for reasonable causes of encephalitis like Infection, tumor, and metabolic syndromes. Pharmacologic intervention began with the use of methylprednisolone and IVIG for 5 days. Patient saw significant improvement in functional, neurologic, and cognitive status with complete resolution of previously noted enhancement within the left temporal and left occipital lobe.

Conclusion: Autoimmune encephalitis is largely a diagnosis of exclusion. Diagnostic criteria include neuropsychiatric symptoms, nervous system deficits, seizures, and exclusion of reasonable cause. In the absence of an obvious cause and clinical improvement upon treatment with methylprednisolone, it was safe to assume Autoimmune Encephalitis with an unknown etiology or likely triggered by previous head trauma. This case report implies the need for focus on research exploring autoimmune encephalitis secondary to previous head trauma.

 

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