Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0013421 (dystonia)
 8,418 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To study the frequency and type of movement disorders and correlate these with MRI findings and outcome. Consecutive patients having encephalitis with movement disorders were included. The encephalitides were categorized into Japanese encephalitis (JE), herpes simplex, dengue, mumps, measles and nonspecific, depending on respective ELISA or CSF PCR. The movement disorders were recorded and severity was graded into mild, moderate, severe and markedly severe. Cranial MRI was done on a 1.5 T scanner acquiring T1, T2 and FLAIR sequence, and the location of MRI changes was noted. Outcome was defined at 6 months on the basis of functional status into complete, partial or poor. The type and severity of movement disorders and their relation to outcome was evaluated. Seventy-four out of 209 encephalitis patients had movement disorders; 67.6% of the patients had JE, 51.2% nonspecific and 11.3% dengue encephalitis. Their median age was 19 years and 16 were females. Parkinsonian features were present in 36, dystonia in six and both in 32 patients. The severity of movement disorders ranged between 2 and 4 (scale: none = 0, mild = 1, moderate = 2, severe = 3, markedly severe = 4). Movement disorders were common in males (P = 0.0001), and more frequent in JE (P = 0.03) and those having substantia nigra involvement on MRI (P = 0.03). Dystonia was associated with worse outcome than parkinsonian features only (P = 0.01). Movement disorders are common and severe in JE and are related to typical anatomical involvement.
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PMID:Spectrum of movement disorders in encephalitis. 2064 May 77

Background: Anti-NMDAR encephalitis is the most frequent cause of autoimmune encephalitis. Chikungunya (CHIK) is an arbovirus responsible for outbreaks of fever, cutaneous rash and arthritis in underdeveloped countries, and a trigger for autoimmunity. Case Presentation: We report a five-year-old male patient with fever, myalgia, headache and conjunctivitis for 5 days. After 1 week he developed tonic-clonic seizures and evolved with dystonia and oromandibular dyskinesia followed by onset of focal motor seizures, decreased level of consciousness, dysautonomia and central apnea. Brain MRI was normal, CSF analysis revealed 15 cells, protein 16.6 mg/dL and glucose 68 mg/dL. Anti-NMDAR antibodies were detected in serum and CSF after 3 weeks of symptom onset. CHIK serology was positive for both IgM and IgG, suggesting a recent infection. Dengue and Zika serologies were negative. CSF PCR for herpes viruses and arboviruses (CHIK, Dengue and Zika) were negative. Conclusion: We report the occurrence of anti-NMDAR encephalitis after acute CHIK infection. The biphasic course, positivity for both CHIK IgM and IgG and negative CHIK CSF PCR results, as well as a dramatic response to immunotherapy suggest an immune-mediated pathogenesis. Because of the global epidemic of CHIK infection and unknown mechanisms involving CHIK and autoimmunity, patients with acute CHIK infections and neurological manifestations should be considered for antineuronal antibody testing.
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PMID:NMDAR Encephalitis Associated With Acute Chikungunya Virus Infection: A New Trigger? 3242 7