記述言語：英語   掲載種別：研究論文（学術雑誌）  

Anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis is an autoimmune encephalitis, and 46% of women with anti-NMDAR encephalitis have tumors, of which 94% are ovarian teratomas. Patients with anti-NMDAR encephalitis rarely have extra-ovarian teratomas, particularly extra-ovarian mature cystic teratomas arising from the retroperitoneum. We herein report a 27-year-old woman who was diagnosed with anti-NMDAR encephalitis caused by a teratoma arising from the retroperitoneum. In patients with anti-NMDAR encephalitis, it is important to perform a systemic search, including for extra-ovarian teratomas. Plasma exchange significantly improved the patient's clinical symptoms.

DOI： 10.2169/internalmedicine.4028-24

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Details of in-hospital stroke are unknown. This study aimed to clarify the incidence rate and risk factors for in-hospital stroke among all inpatients. METHODS: This retrospective single-center study included consecutive patients admitted to our hospital. Patients aged <18 years, discharged within 24 h, and admitted to the neurology and neurosurgery departments were excluded. The incidence rate for in-hospital stroke was calculated, and patients were divided into stroke and control groups based on ischemic stroke occurrence, and the risk factors were assessed using multivariate analysis. RESULTS: Of the 83,990 enrolled patients, 101 (0.12%) developed stroke. The stroke group had a higher proportion of patients with older age (76 vs 69 years; P <.01), hypertension (49% vs 26%; P <.01), diabetes mellitus (34% vs 22%; P =.01), atrial fibrillation (25% vs 8%; P <.01), cardiovascular disease (20% vs 11%; P =.01), and emergency admission (68% vs 32%; P <.01) compared to the control group. The risk factors for in-hospital stroke were old age (odds ratio [OR], 1.03; P <.01), hypertension (OR, 1.57; P =.04), diabetes mellitus (OR, 1.61; P =.03), atrial fibrillation (OR, 2.43; P <.01), emergency admission (OR, 3.38; P <.01), and low serum albumin (OR, 0.66; P =.03). CONCLUSION: The incidence rate of in-hospital stroke was 0.12% and the independent risk factors were old age, history of hypertension, diabetes mellitus, atrial fibrillation, emergency admission, and low serum albumin.

DOI： 10.1272/jnms.JNMS.2025_92-209

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: We assessed microvessel flow within peripheral nerves using nerve sonography in patients with peripheral neuropathy. METHODS: This study included consecutive patients with peripheral neuropathy who were admitted to our hospital. The patients were divided into two groups: inflammatory neuropathies for immune-mediated neuropathies, such as Guillain - Barré syndrome and chronic inflammatory demyelinating polyneuropathy, and the rest were defined as non-inflammatory neuropathies. We assessed nerve size and intraneural blood flow at four sites on each median and ulnar nerve. Blood flow was evaluated using color Doppler imaging, advanced dynamic flow (ADF), and superb microvascular imaging (SMI) techniques. RESULTS: Thirty-nine patients (median age, 60.0 years; 20 male) were enrolled in this study. An increase in intraneural blood flow was observed in five patients when evaluated by color Doppler, five patients by ADF, and 13 patients by SMI. An overall analysis of the three methods showed that intraneural blood flow was significantly higher in patients with inflammatory neuropathy than in those with non-inflammatory neuropathy (54.2% vs. 0%, p = 0.0005). CONCLUSIONS: Intraneural hypervascularization is more frequent in patients with inflammatory neuropathy than in those with non-inflammatory neuropathy. SIGNIFICANCE: Evaluation of microvessel flow within peripheral nerves may contribute to the diagnosis of peripheral neuropathy.

DOI： 10.1016/j.clinph.2024.08.011

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

The pathophysiology of unilateral cortical fluid-attenuated inversion recovery (FLAIR)-hyperintense lesions in anti-myelin oligodendrocyte glycoprotein (MOG)-associated encephalitis with seizures (FLAMES) is unclear. A 26-year-old man was referred because of a seizure. FLAIR showed an increased signal intensity and swelling of the right frontal cortex. His symptoms and imaging abnormalities were improved after intravenous methylprednisolone therapy. MOG antibody was detected both in serum and cerebrospinal fluid (CSF). Therefore, the patient was diagnosed with FLAMES. Myelin basic protein (MBP) was elevated in CSF. The high MBP value in the CSF in the present case suggested that demyelination as well as inflammation can occur in some FLAMES patients.

DOI： 10.2169/internalmedicine.9439-22

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