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- Title
Encefalitis de von Economo.
- Authors
Van Den Berghe, Juanita López; Javier Meza, Francisco; Ponce de León, Isabel Ruiz; Pablo Rojas, Juan; Edgardo Castillo, Gastón
- Abstract
Introduction: In 1917, Constantin von Economo reported multiple cases of neurological manifestations secondary to the Spanish flu pandemic. He classified them into three main clinical forms: somnolent-ophthalmoplegic, mutism and hyperkinetic, causing sequelae resembling Parkinson´s disease. Objective: to present a case of a recent appearance rare disease entity, in Cali Colombia, receiving appropriate management in the Intensive Care Unit (ICU). Case presentation: 9-year-old patient presenting with limb muscle weakness, dysarthria and somnolence, evidencing progressive neurological deterioration requiring admission to the ICU for management. A diagnosis of encephalitis lethargica (EL) was made by the attending multidisciplinary team and management with plasmapheresis and immunosuppression was started, obtaining significant improvement. Discussion and conclusions: as the prevalence is low, the diagnosis requires a high level of suspicion in cases presenting with infectious conditions prior to the development of symptoms, since it is considered an autoimmune cross-reaction against substantia nigra antigens. Alterations in brain imaging or in cerebrospinal fluid cytometry may be found in some cases. Management with methylprednisolone pulse therapy and filtration plasmapheresis provides significant improvement with a decrease in future sequelae.
- Subjects
INFLUENZA pandemic, 1918-1919; PARKINSON'S disease; SUBSTANTIA nigra; INTENSIVE care units; MUSCLE weakness
- Publication
Repertorio de Medicina y Cirugía, 2022, Vol 31, Issue 1, p79
- ISSN
0121-7372
- Publication type
Article
- DOI
10.31260/RepertMedCir.01217372.1146