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Query: UMLS:C0014070 (encephalomyelitis)
 13,017 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In the original description by van Bogaert and De Busscher of subacute sclerosing leukoencephalitis (SSLE), great emphasis was placed upon the involvement of the white matter, a feature that, in addition to the absence of inclusion bodies, differentiated it from subacute inclusion body encephalitis (SIBE) of Dawson. Subsequently, the common features, primarily clinical, electroencephalographic and immunological led to the consolidation of both into the entity known as subacute sclerosing panencephalitis (SSPE). The white matter lesions of SSLE are identical to those that are seen in progressive rubella encephalitis, subacute AIDS encephalomyelitis, tropical spinal paraparesis due to HTLV-1, and visna of Icelandic sheep, but, more importantly, are characterized by the perivascular edema, inflammation and demyelination known in acute, immune-mediated post-infectious and post-vaccinal acute disseminated encephalomyelitis (ADEM). Furthermore, in SSLE and in the other conditions resulting from a persistent viral infection, deposits of immune complexes can be demonstrated in the walls of small cerebral blood vessels. There is therefore strong evidence to suggest that in SSLE as well as in the other persistent viral infections, in addition to the actual invasion by the virus, there is a contemporaneous immune-mediated response to this virus which is responsible for most, perhaps even all of the disseminated, extensive demyelination observed in these conditions. It is also suggested that SSLE and SIBE, sharing a common etiology, may represent two different phenotypic expressions of the same process.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Notes on the pathogenesis of subacute sclerosing panencephalitis. 218 85

Four murine anti-idiotypic (a-Id) hybridoma antibodies were produced against immunoglobulins (Ig) present in the cerebrospinal fluid (CSF) obtained from an MS patient 2 mo after the onset of disease. The four a-Id antibodies were shown to delineate idiotopes present on three distinct Ig subpopulations designated ID-19, ID-40, and ID-97. All three Ig subpopulations were produced in part by intrathecally localized B cells, together making up approximately 5% of the total CSF-Ig 2 mo after the onset of disease. Longitudinal analysis of the concentration of these Ig subpopulations in CSF showed that two subpopulations, ID-40 and ID-97, exhibited a regular relation to the clinical course of the disease, i.e., were decreased (ID-40) or increased (ID-97) in the first CSF sample obtained after two consecutive exacerbations. Screening of sera from 52 optic neuritis patients and 51 heterologous MS patients revealed that one MS patient's serum contained an Ig subpopulation that was idiotypically cross-reactive with ID-97. So far, screening of these Ig subpopulations for reaction with several viruses (measles, parainfluenza type 1, influenza type A, cytomegalovirus, herpes simplex virus, rubella virus, poliovirus, murine encephalomyelitis viruses, and reovirus) and myelin basic protein has failed to reveal their antigen specificities.
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PMID:Longitudinal analysis of three intrathecally produced immunoglobulin subpopulations in an MS patient. 257 10

Two children are described with postnatally acquired acute rubella which induced neurological disease. The first patient with restricted transverse myelitis (Th 11-12) was remarkable for the positive result obtained by the magnetic response (MR) technique of the spinal cord. In the second patient the clinical examination demonstrated a circumscribed, however severe, lasting defect in the extrapyramidal motor system with facial muscle dystonia and complete anarthria; in the latter case the CSF contained rubella specific IgM five days after the onset of exanthema. No abnormalities were noticed by MR five weeks after the clinical onset. The possible significance of MR imaging in virus-induced encephalomyelitis is discussed.
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PMID:Rubella myelitis and encephalitis in childhood. A report of two cases with magnetic resonance imaging. 360 Oct 2

We studied 19 patients with postinfectious encephalomyelitis complicating natural measles-virus infections, and our results support the hypothesis that this demyelinating disease has a pathogenesis similar to that of experimental allergic encephalomyelitis. Early myelin destruction was demonstrated by the presence of myelin basic protein in cerebrospinal fluid, and lymphocyte proliferative responses to myelin basic protein were found in 8 of 17 patients tested. A lack of intrathecal synthesis of antibody against measles virus suggests that measles encephalomyelitis may not be dependent on virus replication within the central nervous system. Similar lymphoproliferative responses to myelin basic protein of lymphocytes from single patients with encephalomyelitis after rabies vaccine or after varicella or rubella virus infections suggest a common immune-mediated pathogenesis for the perivenular demyelinating disease that can follow the injection of neural tissues or infection by a variety of viruses.
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PMID:Measles encephalomyelitis--clinical and immunologic studies. 619 51

Two cases of a very rare complication of rubella i.e. a strictly spinal cord lesion developing during the course of the viral infection, are reported. In the first case, there was a flaccid paraplegia which incompletely regressed after two months. In the second case there were only sensory disorders and sphincter disturbances and recovery was complete after one month. The post-eruption encephalomyelitis lesions are of uncertain paphogenesis but the most common hypothesis suggested is that of a delayed hypersensitivity mechanism involving a cell-mediated immunologic reaction. The prognosis of these post-injection neurologic manifestations is difficult to assess, but spinal cord lesions could have a good prognosis.
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PMID:[2 cases of post-measles myelitis]. 672 35

Serological examinations of blood sera from patients with multiple sclerosis (MS), their nearest relatives, and subjects of the control groups for antibodies to causative agents of some viral infections demonstrated antihemagglutinins to measles and rubella viruses in 61%-95.5% of the subjects examined in all the groups, to mumps virus in 53% in MS patients, to tick-borne encephalitis virus in 2.2% in the same group, and in 10.5% in the group of patients with other CNS diseases, and none in healthy subjects. Virus-neutralizing antibodies to human acute encephalomyelitis virus (HAEM) in 28% of the cases, frequently in the stage of remission. Specific IgM to measles virus was found in 41% of MS patients, in 15% of their nearest relatives, and in 19.7% of patients with other CNS diseases, but not in healthy subjects. No differences in the rate of antibody findings to herpes simplex virus types 1 and 2 were observed in the groups examined. The rate of detection of virus-neutralizing antibody to HAEM virus was significantly higher in MS patients with the severity of the course of IV-V degree (20%) than of the II-III degree (8.8%). In the period of MS exacerbation the level of specific IgM to measles virus increased (35.6%), and higher titres of antihemagglutinins were observed in patients with longer duration of the disease and higher degree of its severity.
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PMID:[Detection of antibodies to the causative agents of viral infections in multiple sclerosis patients]. 684 21

Autoreactive T cells specific for myelin basic protein (MBP), a major component of central nervous system (CNS) protein, are frequently found in blood and cerebrospinal fluid of patients with postinfectious encephalomyelitis. This autoimmune syndrome is a CNS complication after infections with a number of different enveloped viruses, e.g. mumps, measles, rubella, influenza and varicella. However, the pathophysiological mechanism leading to this breaking of natural self tolerance in the course of viral infection remains an enigma. A long-lasting hypothesis has suggested that incorporation of cellular (self) proteins into the envelope of budding viruses might be a possible mechanism leading to autosensitization. In a model study we demonstrate here that vesicular stomatitis virus (VSV), grown in myelin protein-expressing cell cultures, is highly efficient in triggering T cell responses to MBP in vitro and can prime autoreactive T cell immune responses in vivo. On the basis of these findings, we suggest that incorporation of CNS membrane components into the viral envelope and subsequent priming of self-reactive immune responses might be the common pathogenic mechanism underlying the postinfectious encephalomyelitis syndrome.
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PMID:Autoimmunity caused by host cell protein-containing viruses. 753 Dec 73

Nine patients below 20 years of age (4 males and 5 females), who were diagnosed to have acute disseminated encephalomyelitis (ADEM) by clinical findings and magnetic resonance imaging (MRI), were reviewed retrospectively. They ranged from 4 months to 20 years of age with an average of 8.6 years. Seven patients (78%) received neurophysiological studies, which included electroencephalography, multimodality evoked potentials (EPs), nerve conduction velocity and/or F-wave measurement. The presentation symptoms were mainly headache, vomiting, consciousness change and motor deficits. Seven (78%) of nine patients had symptoms preceded by fever or upper respiratory tract infections; one (11%) was preceded by trivalent mumps, measles, rubella vaccination and no definite predisposing factor was found in another. Computed tomography (CT) scans were abnormal in five (71 %) of seven children, while MRI showed multiple lesions in seven (78%) of nine children. The lesions in MRI were mainly in the brainstem (n = 6), basal ganglion (n = 5), thalamus (n = 4), periventricular white matter (n = 4) and cerebellum (n = 4). EPs disclosed spinal cord involvement in all patients who received the examination. Peripheral neuropathy was disclosed in one patient. It was concluded that associated radiculoneuropathy is possible in patients with ADEM. Both MRI and neurophysiologic studies are complementary for diagnosis of ADEM.
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PMID:Acute disseminated encephalomyelitis in children: clinical, neuroimaging and neurophysiologic studies. 875 75

Acute disseminated encephalomyelitis (ADEM) occurs late in the course of viral infection, mainly exanthematous diseases such as measles, chicken pox, and rubella. Postinfectious encephalomyelitis is characterized by immune-mediated demyelination, which is found in experimental autoimmune encephalomyelitis (EAE), and virus cannot be isolated from the central nervous system. The investigations using animal models infected with. Theiler's virus or measles virus would be very useful for clarifying the mechanisms of demyelination induced by viral infection. Although the incidence of postvaccinal encephalomyelitis has fallen markedly due to development of vaccines, the neurological complications following immunization are still reported. The vaccines prepared from viruses other than live-attenuated viruses and whole-killed organisms have never been proved to induce ADEM.
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PMID:[Acute disseminated encephalomyelitis]. 910 97

The patient is a 10-year-old male who experienced somnolence and incomplete quadriplegia after headache and vomiting, without exanthema, for 3 days. The clinical course and magnetic resonance imaging findings of the brain and spinal cord were compatible with acute disseminated encephalomyelitis. The serologic examination revealed that the patient had rubeola because titers of IgM and IgG antibody to measles virus measured by enzyme immunoassay were 0.91 and 40 (cutoff = 0.80 and 2), respectively, at 5 weeks after the onset, the IgM titer had become negative (0.56), and the IgG titer had decreased to 17.7 at 13 weeks after the onset. Because the patient had received a measles-mumps-rubella vaccine at 12 months of age, the acute disseminated encephalomyelitis was thought to be attributed to the modified measles resulting from measles vaccine failure.
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PMID:Acute disseminated encephalomyelitis with probable measles vaccine failure. 1037 90


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