A5078656952- Autoimmune Neurological Disorders and Treatments
- Peripheral Neuropathies and Disorders
- Infectious Encephalopathies and Encephalitis
- Herpesvirus Infections and Treatments
- Epilepsy research and treatment
- Mosquito-borne diseases and control
- Cancer Immunotherapy and Biomarkers
- Long-Term Effects of COVID-19
- Brain Metastases and Treatment
- Cytomegalovirus and herpesvirus research
- Neurological and metabolic disorders
- Glioma Diagnosis and Treatment
- Intensive Care Unit Cognitive Disorders
- Genetics and Neurodevelopmental Disorders
- Neurological Complications and Syndromes
- Prion Diseases and Protein Misfolding
- RNA regulation and disease
- Radiopharmaceutical Chemistry and Applications
- Hospital Admissions and Outcomes
- Neurology and Historical Studies
- Emergency and Acute Care Studies
- Acute Ischemic Stroke Management
- Family and Patient Care in Intensive Care Units
- Polyomavirus and related diseases
- Cerebrospinal fluid and hydrocephalus
Johns Hopkins University
2016-2025
Johns Hopkins Medicine
2015-2025
Johns Hopkins Hospital
2014-2025
Brigham and Women's Hospital
2024
Icahn School of Medicine at Mount Sinai
2019-2022
Children's Hospital of Philadelphia
2022
University of Pennsylvania
2022
Neurology, Inc
2022
Encephalitis Society
2021
University of Liverpool
2021
The aims of this study were to determine the etiology, clinical features, and predictors outcome new-onset refractory status epilepticus. Retrospective review patients with epilepticus without etiology identified within 48 hours admission between January 1, 2008, December 31, 2013, in 13 academic medical centers. primary measure was poor functional at discharge (defined as a score >3 on modified Rankin Scale). Of 130 cases, 67 (52%) remained cryptogenic. most common etiologies autoimmune...
<h3>Importance</h3> Paraneoplastic encephalitides usually precede a diagnosis of cancer and are often refractory to immunosuppressive therapy. Conversely, autoimmune reversible conditions that can occur in the presence or absence cancer. <h3>Objective</h3> To report induction encephalitis 2 patients after treatment metastatic with combination immune checkpoint inhibitors nivolumab ipilimumab. <h3>Design, Setting, Participants</h3> A retrospective case study was conducted clinical management...
To describe a case series of adult patients in the intensive care unit super-refractory status epilepticus (SRSE; refractory lasting 24 hours or more despite appropriate anesthetic treatment) who received treatment with ketogenic diet (KD).We performed retrospective review at 4 medical centers SRSE treated KD. Data collected included demographic features, clinical presentation, diagnosis, EEG data, anticonvulsant treatment, and timing duration Primary outcome measures were resolution (SE)...
To compare the rate of abnormal brain metabolism by FDG-PET/CT to other paraclinical findings and describe patterns in autoimmune encephalitis (AE).A retrospective review clinical data initial dedicated studies for neurology inpatients with AE, per consensus criteria, treated at a single tertiary center over 123 months. Z-score maps were made using 3-dimensional stereotactic surface projections comparison age group-matched controls. Brain region mean Z-scores magnitudes ≥2.00 interpreted as...
To investigate the feasibility, safety, and efficacy of a ketogenic diet (KD) for superrefractory status epilepticus (SRSE) in adults.We performed prospective multicenter study patients 18 to 80 years age with SRSE treated KD treatment algorithm. The primary outcome measure was significant urine serum ketone body production as biomarker feasibility. Secondary measures included resolution SRSE, disposition at discharge, KD-related side effects, long-term outcomes.Twenty-four adults were...
Diagnosis of autoimmune encephalitis presents some challenges in the clinical setting because varied presentations and delay obtaining antibody panel results. We examined role neuroimaging encephalitides, comparing utility <sup>18</sup>F-FDG PET/CT versus conventional brain imaging with MRI. <b>Methods:</b> A retrospective study was performed assessing positivity rate MRI during initial workup 23 patients proven to have antibody-positive encephalitis. studies were analyzed both qualitatively...
Immune checkpoint inhibitors (ICIs) may cause immune-related adverse events (irAEs). Methods to obtain real-time multidisciplinary input for irAEs that require subspecialist care are unknown. This study aimed determine whether a virtual toxicity (IR-tox) team of oncology and medicine subspecialists would be feasible implement, used by providers, identify patients whom is sought.Patients treated with ICIs referred the IR-tox in August 2017 through March 2018 were identified. Feasibility was...
To compare brain metabolism patterns on fluorodeoxyglucose (FDG)-PET/CT in anti-NMDA receptor and other definite autoimmune encephalitis (AE) to assess how these differ between neurologic disability groups.Retrospective review of clinical data initial dedicated FDG-PET/CT studies for neurology inpatients with AE, per published consensus criteria, treated at a single academic medical center over 10-year period. Z-score maps were made using 3-dimensional stereotactic surface projections...
Abstract Background Early diagnosis of encephalitis involves identifying signs neuroinflammation, including cerebrospinal fluid (CSF) pleocytosis. However, an absence CSF pleocytosis in has been described, most notably autoimmune encephalitis. We examined clinical characteristics and outcomes associated with the or presence white blood cell (≥5 cells/µL), to inform timely management Methods This retrospective study compares initial profiles 597 adult patients all-cause Results Of patients,...
Immune checkpoint inhibitors (ICI) have revolutionized cancer treatment but can trigger immune-related encephalitis. We report one of the largest case series patients with encephalitis and review literature. Retrospective literature review. Fourteen treated ICI (50% combination therapy) developed Diagnostic testing revealed cerebral spinal fluid (CSF) lymphocytic pleocytosis (85%) elevated protein (69%), abnormal brain magnetic resonance imaging(MRI) (33%) or FDG-PET (25%),...
To assess the inpatient hospitalization burden and costs of patients with autoimmune encephalitis (AE) at a tertiary care institution.Adult inpatients AE were identified retrospectively from July 1, 2005, to June 30, 2015. Demographic clinical data collected analyzed. Billing compared those herpes simplex (HSE). Charges adjusted for inflation.Of 244 admissions reviewed, 63 met criteria probable or definite AE. Thirty-one (49%) antibody positive, 27 (43%) admitted intensive unit (ICU). Median...
Background: The presence of co-existent neuronal antibodies (neuronal-IgG) in patients with myelin oligodendrocyte glycoprotein immunoglobulin G (MOG-IgG1) is not yet well understood. Objectives: aim this study was to investigate the co-existence a broad range neuronal-IgG MOG-IgG1+ patients. Methods: were tested for 17 neuronal-IgGs cerebrospinal fluid (CSF) and serum including NMDA-R-IgG, AMPA-R-IgG, GABAB-R-IgG, LGI1-IgG, CASPR2-IgG, GABAA-R-IgG, GAD65-IgG, mGLUR1-IgG, DPPX-IgG,...
This study compared neurologic disability and adaptive function in children adults >1 year following anti- N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis diagnosis. Retrospective record review identified 12 patients with anti-NMDAR encephalitis. At last follow-up, all surviving had “good” modified Rankin Score (0-2). Four children, 6 adults, their families participated a telephone interview. Median duration since diagnosis was similar for (2.42 years, interquartile range...
Encephalitis represents a challenging condition to diagnose and treat. To assist physicians in considering autoimmune encephalitis (AE) sooner, we developed validated risk score.The study was conducted as retrospective cohort of patients with diagnosis definite viral (VE) AE from February 2005 December 2019. Clinically relevant statistically significant features between cases VE were explored bivariate logistic regression model results used identify variables for inclusion the score. A...
Anti-leucine glioma-inactivated protein 1 (anti-LGI1) autoimmune encephalitis (AE) presents as subacute memory loss, behavioral changes, and seizures. Diagnosis treatment delays can result in long term sequelae, including cognitive impairment. 18F-FDG PET/CT may be more sensitive than MRI patients with AE. Our objective was to determine if anti-LGI1 is associated a distinct pattern of FDG uptake whether this persists following treatment.Nineteen18F-FDG brain scans (13 pre-treatment, 6...
Anti-N-methyl-d-aspartate receptor (anti-NMDAR) autoimmune encephalitis is an increasingly recognized cause of limbic (LE). Prolonged LE and status epilepticus (LSE) share many features. The ability to distinguish between the two crucial in directing appropriate therapy because potential iatrogenesis associated with immunosuppression anesthetic-induced coma.A 34-year-old woman recurrent developed behavioral changes, global aphasia, repetitive focal generalized tonic-clonic seizures. Because...
Although many hospitalized neuroscience patients have physical and occupational therapy (rehabilitation) needs, with none or minimal impairments frequently receive rehabilitation consultation, diverting from greatest need.A multidisciplinary team on the general cerebrovascular neurology acute inpatient services mapped consultation process, resulting in multiple implemented interventions including physician education appropriate consultations, modification of rounds, discussion patient needs...
<h3>Background and Objectives</h3> To evaluate the impact of fatigue after autoimmune encephalitis, determine associations with patients9 characteristics, identify factors that contribute to its development. <h3>Methods</h3> In a first cohort recruited via several encephalitis support organizations, self-reported questionnaires were used fatigue, depression, sleep quality in adults encephalitis. second where more in-depth clinical characterization could be performed, from 2 tertiary...