Obraz purulentního zánětu centrálního nervového systému v rámci suspektní autoimunitní encefalitis s dobrou odpovědí na kortikoterapii // SOLEN

Neurológia pre prax 1/2026

Clinical presentation of purulent inflammation of central nervous system in possible autoimmune encephalitis with a good response to corticotherapy

Encephalitis is a serious inflammatory disease of the brain that involves a complex differential diagnostic assessment due to the wide range of possible causes. This report presents a case of a 71-year-old patient who underwent neurosurgery and subsequently developed subacute cognitive deterioration and recurrent epileptic seizures. The diagnosis of autoimmune encephalitis was prolonged due to a premorbidly diagnosed and treated structural epilepsy and the detection of serous to purulent encephalitis, which presented an atypical cerebrospinal fluid profile. Due to the lack of evidence of an infectious cause and suspicion of autoimmune encephalitis, it was decided to administrate a total dose of 2.5 g of methylprednisolone followed by maintenance immunosuppressive therapy, after which the patient's condition improved rapidly, as evidenced by both clinical examination and extensive neuropsychological evaluation.

Keywords: autoimmune encephalitis, anti-titin antibodies, neuroinfection, onconeural antibodies