Brainstem encephalitis: etiologies, treatment, and predictors of outcome.

Brainstem encephalitis (BE) is an uncommon condition. We sought to characterize clinical presentations, etiologies, response to treatment, and predictors of outcome. We performed a retrospective review of non-HIV infected patients diagnosed with BE at Johns Hopkins Hospital (January 1997-April 2010).

HIV-associated opportunistic infections of the CNS.

Survival in people infected with HIV has improved because of an increasingly powerful array of antiretroviral treatments, but neurological symptoms due to comorbid conditions, including infection with hepatitis C virus, malnutrition, and the effects of accelerated cardiovascular disease and ageing, are increasingly salient. A therapeutic gap seems to exist between the salutary effects of antiretroviral regimens and the normalisation of neurological function in HIV-associated neurocognitive disorders. Despite the advances in antiretroviral therapy, CNS opportunistic infections remain a serious burden worldwide.

Peripheral nerve toxic effects of nitrofurantoin.

Objective: To investigate the role of skin biopsy in nitrofurantoin peripheral neuropathy.

Design: We describe the clinical features and skin biopsies of 2 cases of non-length-dependent small-fiber neuropathy/ganglionopathy attributable to nitrofurantoin.

Setting: Clinical evaluation and skin biopsies were performed at a tertiary teaching hospital in Baltimore, Maryland.

Neuromuscular complications in HIV: effects of aging.

There has been speculation that chronic HIV infection is a condition of accelerated aging that may lead to early onset of disease in multiple organ systems. The neuromuscular disorders of HIV, in particular distal symmetric polyneuropathy and myopathies, are also seen in the general population among older patients. As the HIV-infected population ages, there may be deleterious synergistic effects of age and chronic HIV infection on the brain, peripheral nerve, and muscle.

Severe Guillain-Barré syndrome following head trauma.

Fulminant forms of Guillain-Barré syndrome (GBS) present as acute onset tetraparesis and areflexia with absent brainstem reflexes, simulating brain death. Head trauma as an antecedent to fulminant GBS has been infrequently reported, and recognizing an association between GBS and head trauma may be crucial for patient management. Consequently, we report a patient with fulminant GBS with mixed demyelinating and axonal features preceded by a closed head injury, and discuss the possible pathophysiological mechanisms.