Immune-mediated post-infectious brain stem encephalitis mimicking Leigh syndrome

Abstract EN

Immune-mediated brainstem encephalitis is a presumed post-infectious neurological disorder.

We describe two patients who presented with acute onset neurological symptoms indicating brain stem pathology in which MRI showed bilateral symmetrical brainstem changes suggesting the diagnosis of Leigh Syndrome, an untreatable progressive mitochondrial disorder.

In contrast, immune mediated encephalitis may respond well to intravenous immunoglobulin or steroids as in the cases presented.

We concluded that in cases of acute brain stem dysfunction the diagnosis of acute post-infectious immune mediated brain stem encephalitis must be considered.

Therapy for immune mediated encephalitis must be considered especially when there are symmetrical MRI changes as this does not always indicate an untreatable metabolic disorder.