Elevated cerebrospinal fluid IgG index in acute cerebellitis presenting with sudden onset headache

Kyung Yeon Lee; Kun-Soo Lee
June 2014
Neurology Asia;Jun2014, Vol. 19 Issue 2, p211
Academic Journal
Case Study
Acute cerebellitis is a rare inflammatory syndrome and is one of the important causes of acute cerebellar dysfunction in children. The cerebrospinal fluid (CSF) IgG index is most often tested clinically in the diagnosis of multiple sclerosis. However, it is not specific to multiple sclerosis, and can be elevated in a variety of neurologic diseases. A 7-year-old boy with acute cerebellitis presenting with sudden onset headache and subtle cerebellar dysfunction demonstrated an elevated CSF IgG index (1.1) and an absence of oligoclonal bands. On the seventeenth day, the follow-up CSF IgG index was 0.71. Two-month and one-year follow-up magnetic resonance imaging revealed cerebellar atrophy, although the patient showed no neurologic deficit. To the best of our knowledge, this case report is the first to describe acute cerebellitis accompanied by an elevated CSF IgG index and an absence of CSF oligoclonal IgG bands. These findings suggest that a breach in the blood-brain-barrier might occur in acute cerebellitis.


Related Articles

  • Diagnosis of multiple sclerosis. McDonald, W.I. // BMJ: British Medical Journal (International Edition);9/9/89, Vol. 299 Issue 6700, p635 

    Focuses on the technique used in the diagnosis of multiple sclerosis in Great Britain. Use of magnetic resonance imaging for showing lesions in multiple sclerosis; Analysis of proteins in the cerebrospinal fluid to detect immunological abnormalities; Increase in the risk of the disease due to...

  • Multiple Sklerozda Ayırıcı Tanı. Karataş, Mehmet // Journal of Neurological Sciences;2008, Vol. 25 Issue 2, p171 

    In some cases, the diagnosis and the differential diagnosis of multiple sclerosis (MS) are difficult. Because no specific test for MS is available, the diagnosis of MS is based on evidence from the history, neurological findings, MRI, CSF examination and evoked potentials. These diagnostic tests...

  • A proposed modification to the McDonald 2010 criteria for the diagnosis of primary progressive multiple sclerosis. Kelly, SB; Kinsella, K; Duggan, M; Tubridy, N; McGuigan, C; Hutchinson, M // Multiple Sclerosis Journal;Jul2013, Vol. 19 Issue 8, p1095 

    The article presents a study which examines the sensitiveness of the diagnostic standards for primary-progressive multiple sclerosis (PPMS) with reference to spinal cord measure and analyze the use of cerebrospinal fluid oligoclonal bands (CSFOBs). The study identifies the diagnoses of PPMS...

  • Diagnostics in Multiple Sclerosis. Buckley, Rita // MD Conference Express;Apr2012, Vol. 12 Issue 2, p4 

    This article discusses reasons for and against lumbar puncture in the diagnosis of multiple sclerosis, as well as reasons for an against using MRI for therapeutic decisions.

  • OLIGOCLONAL BANDING AND CSF MARKERS IN MULTIPLE SCLEROSIS: ASSOCIATIONS WITH DISEASE COURSE AND PROGRESSION. Lourenco, Pedro; Shirani, Afsaneh; Saeedi, Jameelah; Oger, Joel; Schreiber, William; Tremlett, Helen // UBC Medical Journal;Apr2011, Vol. 2 Issue 2, p16 

    Background: Oligoclonal bands (OCBs) and CSF markers are useful in the diagnosis of MS. However, their role in disease course determination and prognosis is poorly defined. Here, we studied the association of OCB status and CSF markers with disease-course and progression. We also examined the...

  • Cerebrospinal Fluid Myelin Basic Protein Is Frequently Ordered but Has Little Value. Greene, Dina N.; Schmidt, Robert L.; Wilson, Andrew R.; Freedman, Mark S.; Grenache, David G. // American Journal of Clinical Pathology;Aug2012, Vol. 138 Issue 2, p262 

    Diagnosis of multiple sclerosis (MS) is facilitated by analyzing biochemical properties of cerebrospinal fluid (CSF). Oligoclonal bands (OCBs) and tmmunoglobulin G (IgG) index are well-established markers for evaluating patients suspected of having MS. Myelin basic protein (MBP) is also ordered...

  • Genetic variants are major determinants of CSF antibody levels in multiple sclerosis. Goris, An; Pauwels, Ine; Gustavsen, Marte W.; van Son, Brechtje; Hilven, Kelly; Bos, Steffan D.; Celius, Elisabeth Gulowsen; Berg-Hansen, Pål; Aarseth, Jan; Myhr, Kjell-Morten; D’Alfonso, Sandra; Barizzone, Nadia; Leone, Maurizio A.; Martinelli Boneschi, Filippo; Sorosina, Melissa; Liberatore, Giuseppe; Kockum, Ingrid; Olsson, Tomas; Hillert, Jan; Alfredsson, Lars // Brain: A Journal of Neurology;Mar2015, Vol. 138 Issue 3, p632 

    The presence of antibodies in the CSF is a hallmark of multiple sclerosis, but reasons for patient-to-patient differences in antibody levels remain largely unknown. In a genome-wide association screen of almost 7000 patients from 9 countries, Goris et al. identify six genetic variants that...

  • The Demographic, Clinical, and Magnetic Resonance Imaging (MRI) Features of Transverse Myelitis in Children. Thomas, Terrence; Branson, Helen M.; Verhey, Leonard H.; Shroff, Manohar; Stephens, Derek; Magalhaes, Sandra; Banwell, Brenda // Journal of Child Neurology;Jan2012, Vol. 27 Issue 1, p11 

    The authors collected demographic, clinical, and neuroimaging data prospectively on 38 children with transverse myelitis. One child died during the illness. The female:male ratio was 1.2:1 for children under age 10 years and 2.6:1 over age 10 years. Twenty-eight (74%) reported a prodromal event....

  • Lesion morphology at 7 Tesla MRI differentiates Susac syndrome from multiple sclerosis. Wuerfel, Jens; Sinnecker, Tim; Ringelstein, E Bernd; Jarius, Sven; Schwindt, Wolfram; Niendorf, Thoralf; Paul, Friedemann; Kleffner, Ilka; Dörr, Jan // Multiple Sclerosis Journal;Nov2012, Vol. 18 Issue 11, p1592 

    The article presents research that examines the potential benefit of 7 Tesla (7T) magnetic resonance imaging (MRI) for the differentiation between multiple sclerosis (MS) and Susac syndrome as well as the clarification of Susac pathogenesis. Study shows the presence of cerebrospinal...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics