Aseptic meningoencephalitis during nusinersen therapy in a patient with type III spinal muscular atrophy: a case report

• DOI: 10.1016/j.nmd.2025.105365
• Publication Date: 2025-04-17T12:33:28Z
• Authors: Lukasz Kolakowski; Olivia Zschau; Jérôme Bonzon; Anthony de Vere-T...; Marina Herwerth; Christoph Neuwirth; Michael Weller; Patrick Roth; Bettina Schreiner; Veronika Kana

Nusinersen, an intrathecally-administered antisense oligonucleotide for the treatment of spinal muscular atrophy (SMA), may rarely cause mild aseptic meningitis early in treatment. We report a severe late-onset brain stem meningoencephalitis 42-year-old man with type III SMA, occurring 38 months after starting nusinersen. The patient showed clinical and radiological signs significant CSF neutrophilic pleocytosis, despite negative infectious disease tests. After high-dose steroids tapering, symptoms imaging findings resolved. This case suggests potential link between nusinersen adult extending previous reports rare drug-induced meningitis. Physicians should consider this as possible adverse event patients undergoing intrathecal therapy.