Refractory brainstem encephalitis mimicking progressive cerebral infarction: infliximab and methotrexate as a salvage immunotherapy
| Title: | Refractory brainstem encephalitis mimicking progressive cerebral infarction: infliximab and methotrexate as a salvage immunotherapy |
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| Authors: | Sung-Ho Ahn, Jieun Roh, Kyoung-Nam Woo, Hyun-Sung Kim, Min-Gyu Park, Kyung-Pil Park, Seung-Kug Baik, Jin-Hong Shin |
| Source: | Journal of Neurocritical Care, Vol 14, Iss 1, Pp 46-51 (2021) |
| Publisher Information: | The Korean Neurocritical Care Society, 2021. |
| Publication Year: | 2021 |
| Collection: | LCC:Neurology. Diseases of the nervous system |
| Subject Terms: | brainstem encephalitis, subacute cerebral infarction, infliximab, immunotherapy, Neurology. Diseases of the nervous system, RC346-429 |
| More Details: | Background Brainstem encephalitis is a rare, severe, and potentially life-threatening inflammation of the central nervous system, exhibiting various treatment responses and outcomes owing to multiple etiologies. Case Report We describe the favorable outcome of salvage immunotherapy using a combination of infliximab and methotrexate in a 62-year-old woman with refractory brainstem encephalitis. The patient was initially presumed to be at a subacute stage of medullary infarction but showed progressively worsening conditions involving cervical myelopathy, despite having completed the schedule of subsequent immunotherapy with intravenous methylprednisolone, immunoglobulin, and rituximab. After completion of four sessions of weekly rituximab injection, she was treated with 5 mg/kg of infliximab, scheduled at 0, 2, and 6 weeks, along with methotrexate (weekly 12.5 mg). After completion of infliximab injection and maintenance with methotrexate treatment, she showed an improving course of quadriplegia. Conclusion This case report provides evidence for the potential efficacy of infliximab with methotrexate in cases of refractory brainstem encephalitis. |
| Document Type: | article |
| File Description: | electronic resource |
| Language: | English Korean |
| ISSN: | 2005-0348 2508-1349 |
| Relation: | http://e-jnc.org/upload/pdf/jnc-200025.pdf; https://doaj.org/toc/2005-0348; https://doaj.org/toc/2508-1349 |
| DOI: | 10.18700/jnc.200025 |
| Access URL: | https://doaj.org/article/d699c5a0fb27466288bc91f0dae3a349 |
| Accession Number: | edsdoj.699c5a0fb27466288bc91f0dae3a349 |
| Database: | Directory of Open Access Journals |
| ISSN: | 20050348 25081349 |
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| DOI: | 10.18700/jnc.200025 |
| Published in: | Journal of Neurocritical Care |
| Language: | English Korean |