• Internal medicine · Dec 2022

    Case Reports

    A Case Report of FLAMES with Elevated Myelin Basic Protein Followed by Myelitis.

    • Hiroyuki Hokama, Yuki Sakamoto, Toshiyuki Hayashi, Seira Hatake, Mizuho Takahashi, Hiroto Kodera, Akihito Kutsuna, Chikako Nito, Shunya Nakane, Hiroshi Nagayama, Toshiyuki Takahashi, and Kazumi Kimura.
    • Department of Neurology, Graduate School of Medicine, Nippon Medical School, Japan.
    • Intern. Med. 2022 Dec 1; 61 (23): 358535883585-3588.

    AbstractThe 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.

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