Encéphalite aiguë des noyaux gris centraux à Mycoplasma pneumoniae

Mycoplasma pneumoniae-Associated Encephalitis: Favorable Aggressive Immunosuppression in a Patient

“…In the patient described, however, the abnormal signal in the temporoinsular cortex was consistently more attenuated than in ADEM, and likely corresponded to the edematous phase of the inflammatory reaction. Basal ganglia involvement may be the only cerebral manifestation of M. pneumoniae encephalitis, as demonstrated by Fusco et al 7 and El Hafidi et al, 8 and it returned to normal in both patients with immunotherapy; however, an ambiguous definition of "bilateral striatal necrosis" 8 was used for the second patient. Focal edema of the temporoinsular region might also be the neuroimaging sign at the onset of herpes simplex encephalitis-1, but this can be ruled out by the clinical progression, immunology, absence of seizures, and CSF findings in our patient.…”

“…Nervous system involvement is common in Mycoplasma pneumoniae infection and may present as encephalitis, Guillain-Barré syndrome, transverse myelitis, aseptic meningitis, cerebellar ataxia, basal ganglia involvement, axonal neuropathy, polyradiculoneuritis, optic neuritis, ophthalmoplegia, myositis, and posterior reversible encephalopathy syndrome (PRES) [1][2][3][4][5][6][7][8][9][10][11] ; M. pneumoniae-related encephalitis, in particular, accounts for 5 to 10% of all acute cases of childhood encephalitis in Europe. 12 Fever, altered consciousness, and personality or behavioral changes were the most common initial symptoms in a recent pediatric series 12 ; the importance of psychic involvement is confirmed by the unusual occurrence of obsessive-compulsive disorder.…”