Background
Methods
Case presentation
Literature search and selection
Data extraction
Results of literature review
Reported by, location, reference | Case no. | Sex, age (years) | symptomsis | Neurological examination | Etiology |
---|---|---|---|---|---|
Beijing Chaoyang Hospital, China | 1 | M, 37 | Fever, UT | cervical rigidity (+) | NQ |
Tada et al. [1] Japan | 2 | F, 59 | Fever, vertigo, lethargy | NS | NQ |
3 | F, 18 | Fever, seizure, delirium | NS | NQ | |
4 | M, 19 | Fever, cough, delirium, seizure | NS | NQ | |
5 | F, 25 | Fever, vesicular, headache, drowsiness, nausea | NS | VZV | |
6 | M, 22 | Fever, hallucination, delirium | NS | NQ | |
Jun-ichi et al. [22] Japan | 7 | M, 31 | Headache, fever, drowsiness, disorientation, memory disturbance | drowsiness, disorientation, memory disturbance | NQ |
Jeong-Seon et al. [6] Korea | 8 | M, 59 | Dysarthria, drowsiness,fever | Normal | NQ |
Nida Tascilar et al. [27] Turkey | 9 | F, 26 | Fever, headache, phonophobia, photophobia, dizziness, UT | Neck stiffness (+), positive Kernig’s sign, right truncal and gait ataxia | NQ |
Makiko et al. [28] Japan | 10 | F, 23 | Fever, headache, UT | Unsteady gait, patellar tendon reflexes, plantar reflexes, abdominal wall reflexes diminished | NQ |
Henning Vollmann et al. [29] Germany | 11 | M, 42 | Fever, vomit, headache | Mild ataxia, disturbance of gait | Tick-bites |
Dimitri Renard et al. [30] France | 12 | M, 43 | Stuporous state | GCS E4M5V2, mutism, persistent hiccup | Anti-Yo rhombenceh- halitis |
Shingo Mitraki et al. [31] Japan | 13 | M, 29 | Consciousness disturbance | Drowsy, disoriented | pneumonia |
Hideki Shibuya et al. [10] Japan | 14 | M, 30 | Fever, consciousness disturbance | Glasgrow coma scale: E4V1M6 | Mycoplasma- pneumoniae |
Balasubramanyam Shankar et al. [32] India | 15 | F, 28 | Fever, vomiting, paresthesia | Drowsy, neck rigidity, up going plantar reflex | NQ |
Soon Young Ko et al. [33] Korea | 16 | M, 30 | Fever, alalia | dysarthra | Nonfulminant hepatitis A |
Makoto Hibino et al. [34] Japan | 17 | F, 24 | Fever, diarrhea, abdominal pain, weakness of right upper extremity | Right-side hemiparesis, hemianesthesia, Chaddock (+) | adenovirus |
Yuji Tomizawa et al. [11] Japan | 18 | M, 49 | Fever, gait difficulty | Wide-based gait, fine postural tremors, mildly exaggerate deep tendon reflexes | Legionella pneumophila- serogroup 2 |
Robert M et al. [35] America | 19 | M, 41 | Fever, headache, delirium, consciousness disturbance, tremor, gait instability, paresthesias, UT | Slow thought, mild difficulty finding words, intention tremor of the left arm, dysmetria of lower extremities, broad-based gait | ipilimumba |
Jing Jing Pan et al. [36] China | 20 | F, 18 | Fever | (−) | NQ |
21 | M, 26 | Fever, acute UT | Nuchal rigidity (+) | NQ | |
22 | F, 23 | Fever, headache, disturbance of consciousness | Kerning (+) | C-section | |
23 | M, 21 | Fever, headache, acute UT, intestinal obstruction | Kerning (+) | NQ | |
Shuo Zhang et al. [37] China | 24 | F, 26 | Headache, fever, seizure, somnolence | Somnolence | Mycoplasm-a |
25 | F, 34 | Dizziness, fever, somnolence | Somnolence | Mumps virus | |
26 | M,25 | Headache, fever, cognitive impairment, behavioral disorders, confusion | Cognitive impairment, behavioral disorders, confusion | Herpes simplex virus | |
Eylem Degirmenci et al. [38] Turkey | 27 | M, 27 | Headache, apathy, nausea, vomiting | Bilateral papilledema, mildly altered mental status | NQ |
Naila Alakbarvova et al. [39] Turkey | 28 | M, 46 | Headache, vomiting, nausea, diarrea, abdominal pain, generalized tonic-clonic seizure | Confusing with time disorientation | Amanita phalloides intoxication |
Matthias Gawlitza et al. [40] Germany | 29 | F, 28 | disorientated | Disorientated, confusion | Hemolytic uremic syndrome |
Case no. | Initial examination | Treatment | |||||
---|---|---|---|---|---|---|---|
WBC (109/L) | CRP (g/L) | Serum sodium (mmol/L) | CSF WBC (106/L) | MRI | EEG | ||
1 | 10.99 | 9.41 | 131.8 (hyponatremia) | 97 | SCC | NE | mannitol, low dose methylprednisolone, ACV, anti-tuberculosis |
2 | NS | NS | NS | 500 | SCC | Slow BA | ACV, antibiotics |
3 | NS | NS | NS | 17 | SCC | Slow BA and spikes | PB, PSL |
4 | NS | NS | NS | Normal | SCC | Slow BA | ACV, PHT, PSL |
5 | NS | NS | NS | NE | SCC | NE | ACV |
6 | NS | NS | NS | Normal | SCC | Slow BA | ACV, antibiotics, PSL |
7 | 18.8 | 17.0 | NS | 253 | Entire CC and peripheral WM | NS | antibiotics |
8 | normal | normal | normal | normal | SCC and frontal WM | NS | No specific therapy |
9 | normal | normal | normal | 408 | SCC | normal | Ceftriaxone, ACV, ampicillin, catheterization |
10 | normal | normal | normal | normal | SCC, WM | NS | Methylprednisolone pulse, PSL, catheterization |
11 | NS | normal | 132 (hyponatremia) | 33 | SCC | NS | Ceftriaxone, ACV, symptomatic therapy of headache and fever |
12 | NS | normal | 133 (hyponatremia) | 6 | SCC, frontoparie-tal WM, putamina, thalami | Diffuse slowing wave | Antiepileptic treatment, methylprednisolone pulse, immunoglobulin treatment |
13 | elevated | elevated | NS | normal | Entire CC | NS | methylprednisolone pulse, immunoglobulin treatment |
14 | NS | NS | NS | NS | SCC | NS | Levofloxacin |
15 | NS | NS | NS | 60 | SCC, bilateral WM | Slow activity, frontal sharp wave | Empirical corticosteroids and ACV |
16 | 3.48 | NS | 138 | NS | SCC | abnormal | hemodialysis |
17 | normal | 12.21 | normal | NE | SCC | NS | No specific therapy |
18 | elevated | 22.9 | 130 | 3 | SCC | NS | Antibiotics |
19 | normal | normal | normal | 128 | SCC | NS | oral PSL and methylprednisolone pulse |
20 | 6.08 | normal | 137.0 | 90 | SCC | abnormal | methylprednisolone pulse, oral PSL |
21 | 7.10 | normal | 130.2 | 100 | SCC, insula, caudate nucleus | abnormal | Oral methylprednisolone and PSL |
22 | 11.20 | normal | 138.6 | 12 | SCC | abnormal | Oral methylprednisolone and PSL |
23 | 8.20 | normal | 126.5 | 80 | SCC | abnormal | Oral PSL |
24 | NS | NS | NS | 3 | SCC | Occipital slow waves | Mannitol, diazepam, macrolides antibiotics and moxifloxacin |
25 | NS | NS | NS | 7 | SCC | Occipital slow waves | Interferon, ribavirin |
26 | NS | NS | NS | 112 | SCC | Occipital slow waves | Ganciclovir, mannitol, antibiotics |
27 | normal | normal | normal | 150 | SCC | NS | Acetazolamide, antibiotics, oseltamivir |
28 | 17.8 | NQ | normal | normal | SCC | NS | Risperidone, clozapine, venlafaxine and diazepam, antipsychotic and intoxication treatment |
29 | NS | NS | NS | NS | SCC | NS | eculizumab |