Neuromyelitis Optica Spectrum Disorder may share common clinico-radiological features with Wernicke’s encephalopathy. We present a case of untreated hyperthyroidism in a female who presented with thyrotoxicosis and later developed Wernicke’s encephalopathy, possibly contributed by NMOSD-induced recurrent vomiting. This case re-establishes the importance of considering cerebral syndrome, diencephalon syndrome and area postrema syndrome variants of NMOSD while managing a case of metabolic encephalopathy, particularly if neuroimaging features are suggestive.

Optic neuritis after COVID-19 vaccination.

We report a case of transverse myelitis that may have a temporal association with the COVID-19 vaccine. There are others reports in the literature of cases of transverse myelitis with temporal association with the ChAdOx1 nCoV-19 vaccine. It is important to emphasize that it is a temporal association only.

Small-fiber neuropathy is a disorder clinically dominated by neuropathic pain and autonomic symptoms. We present the case of a 21-year-old woman with large- and small-fiber neuropathy associated with systemic idiopathic hypereosinophilic syndrome. Among the most common manifestations of hypereosinophilic syndrome, neurological lesions have been described in the central and peripheral nervous systems. This is the first case with a reported correlation between idiopathic hypereosinophilia with systemic involvement and small-fiber neuropathy.

Anti-GM2 antibodies-associated meningoradiculitis occurred simultaneously with immune restoration in an HIV patient. GM2 is overexpressed on HIV-infected T lymphocytes, and we showed no cross-reactivity between GM2 and HIV-1 glycoproteins in western blot. We believe this case falls within the scope of autoimmune manifestations linked to HIV immune reconstitution inflammatory syndrome.

A 72-year-old woman with anti-acetylcholine receptor antibody-positive generalized myasthenia gravis underwent early fast-acting treatment. Even a modified intravenous high-dose methylprednisolone regimen with a reduced dose of just 250 mg/day for 2 days, given after six cycles of plasmapheresis and 10 mg/day of oral prednisolone for 5 days, triggered a severe myasthenic exacerbation. Although subsequent intravenous immunoglobulin therapy successfully averted a crisis, caution is required when using intravenous high-dose methylprednisolone for early fast-acting treatment of myasthenia gravis, because the risk factors for exacerbation after intravenous high-dose methylprednisolone use, and the best approach for treating the exacerbation, are not yet known.

We describe a unique case of chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids first presenting with a tumefactive infratentorial lesion. Long-term follow up allowed us to observe the evolution toward the typical magnetic resonance imaging pattern of chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids. Anti-CD20 monoclonal antibody rituximab was found to be highly effective in the treatment of this rare disease

On the eighth day of her illness, DWI (b)/FLAIR imaging (h) revealed an oval area of hyperintensity in the splenium of the corpus callosum (arrow), consistent with mild encephalitis/encephalopathy with a reversible splenial lesion, which had disappeared by the 19th day (e, k). On the 19th day, FLAIR revealed bilateral linear and radial hyperintensities in the periventricular white matter (l, arrowheads), and symmetric linear lesions in the thalamus (k, arrowheads). Marble-patterned DWI hyperintensities were also observed in the body of the corpus callosum (f, arrowheads).

Anti-Gal-C antibody positive brainstem lesion that responsive to the immunotherapy.

An adult case of central nervous system lesions due to cytotoxic T-lymphocyte antigen 4 haploinsufficiency was presented. This case suggests that patients with cytotoxic T-lymphocyte antigen 4 haploinsufficiency might show steroid-responsive long spinal lesions.

Here, we present a rare case of encephalopathy associated with coronavirus disease 2019 (COVID-19) in Japan. Base on the clinical and laboratory findings of the case, we will discuss the central nervous system damage associated with COVID-19.