Brainstem encephalitis. A diagnostic dilemma

Brainstem encephalitis (BE) is a rare, severe, and potentially life-threatening inflammation of the central nervous system. Brainstem encephalitis has multiple etiologies, which vary in treatment and outcomes. The current literature is generally focused on the infectious causes of BE, while little i...

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Bibliographic Details
Published in:Neurosciences (Riyadh, Saudi Arabia) Saudi Arabia), 2018-04, Vol.23 (2), p.152-157
Main Authors: Bin Abdulqader, Sarah A, Alkhalidi, Hisham M, Ajlan, Abdulrazag M
Format: Article
Language:English
Subjects:
Brain damage
Case Report
Development and progression
Diagnosis
Diagnostic imaging
Encephalitis
Inflammation
Medical colleges
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Summary:Brainstem encephalitis (BE) is a rare, severe, and potentially life-threatening inflammation of the central nervous system. Brainstem encephalitis has multiple etiologies, which vary in treatment and outcomes. The current literature is generally focused on the infectious causes of BE, while little is known about the other entities, including cases with inconclusive diagnoses. Additionally, the outcomes of BE are not well documented. We present a case of an 18-year-old male who presented with progressive symptoms of brainstem involvement. His clinical investigations, including cerebrospinal fluid (CSF) analysis, were normal; magnetic resonance imaging (MRI) of the brain showed an enhancing medullary lesion, while tissue biopsy yielded no specific diagnosis. Multiple empirical treatments to address possible autoimmune and infectious processes were started with no significant improvement. He continued to deteriorate over a period of 12 weeks. Thereafter, following intensive supportive and rehabilitative care, he started to show slow signs of improvement.
ISSN:1319-6138
1319-6138
DOI:10.17712/nsj.2018.2.20170401