PubMed · 13446309
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A R CRAWFORD, F L ROBINSON. 1957. Necrotizing encephalitis.. https://doi.org/10.1093/brain%2F80.2.209
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Intravenous immunoglobulin (IVIG) with high titers to West Nile virus was used as an adjuvant therapy for a patient with West Nile virus encephalitis that did not respond to supportive care. We present this case report and review the evidence supporting the use of high-titer IVIG.
A 53-year-old man presented with optic neuritis, followed within 10 weeks by a subacute progression of weakness, ataxia, and multiple cranial nerve palsies. Cranial magnetic resonance imaging demonstrated multiple T2-hyperintense lesions extending from the ponto-medullary junction to the thalamus and internal capsule. Cerebrospinal fluid analysis showed lymphocytic pleocytosis with elevated protein content. A brain biopsy revealed inflammatory changes. After a month long period of inexorable worsening, the patient was treated with intravenous immunoglobulins (2 g/kg). He responded to treatment, and recovered over the subsequent 3 months. The patient's response to treatment suggests that intravenous immunoglobulins should be considered in patients with inflammatory brain disorders.
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