VON ECHONOMO´S ENCEPHALITIS. A CASE REPORT Encefalitis de Von Economo

Abstract

Von Economo describes in 1917 multiple cases of neurological manifestations secondary to the Spanish influenza pandemic, classifying it into three large groups: a drowsy-oftalmoplegic form, another characterized by mutism and ultimately a hypercinetic form, additional describes posteriori sequelae with manifestations similar to Parkinson's disease.

The following case describes a clinical picture of a 9-year-old patient with decreased limb strength, dysarthrria and drowsiness that after admission initiates progressive neurological impairment, and requires management in Intensive Care Unit, measured by team multidisciplinary studies, which after multiple studies consider lethargic encephalitis and initiate management with plasmapheresis and immunosuppressive treatment with significant improvement,

For the diagnosis of this disease, being its prevalence so low, it is necessary a high rate of suspicion as the presence of infectious picture prior to the onset of symptoms, since it is considered cross-autoimmune reaction against antigens of the substance nigra. In some cases, alterations may be found in imaging studies or in cerebrospinal fluid cytokine

On the other hand, according to its autoimmune characteristic, the handling with pulses of methylprednisolone or plasma filtration with plasmapheresis shows significant improvement as well as decrease in future sequelae.