Neurology Alert – November 1, 2023

Hepatitis E and Neuropathy

In this prospective case-control study of patents with neuralgic amyotrophy, Guillain-Barré syndrome, and Bell’s palsy, an association with acute hepatitis E infection was demonstrated only with neuralgic amyotrophy.

Early Onset Post-Radiation Neuropathy

Biopsy studies of early onset neuropathies seen after radiation therapy consistently show evidence of microvasculitis and other signs of inflammation. Early and rapid treatment with anti-inflammatory medications may be effective in stopping the progression and speeding up recovery.

Treatable Causes of Rapidly Progressive Dementias

Many cases of rapidly progressive dementia are caused by prion diseases and have no effective treatments. But, with the greater awareness of the presentation for autoimmune encephalitis, these disorders make up an increasing percentage of presenting cases and can be aggressively and successfully treated. The STAM3P score helps to identify potentially treatable cases of this disorder.

Autoimmune Encephalitis After Herpes Simplex Virus Encephalitis

A recent study showed that about 25% of patients with herpes simplex encephalitis develop neurological symptoms three to six weeks after the infection, pointing toward an autoimmune process with different neurological and psychiatric symptoms. Anti-neuronal antibodies, such as anti-N-methyl-D-aspartate receptor antibodies, have been found in this post-viral autoimmune encephalitis presentation.

Acute Vertigo Caused by Herpes Zoster Oticus

Herpes zoster oticus (HZO) and vestibular neuritis (VN) can be difficult to distinguish, but treatments may be different. Magnetic resonance imaging may help by showing inflammatory lesions in the vestibular nuclei or the proximal portions of the eighth nerves in HZO, but not VN.