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Delayed post‐hypoxic leukoencephalopathy with a peculiar autoantibody association
Author(s) -
Coppola Cinzia,
Oliva Mariano,
Saracino Dario,
Cipriano Lorenzo,
Capaldo Guglielmo,
Puoti Gianfranco,
Fratta Mario,
Ugga Lorenzo,
D'Amico Alessandra
Publication year - 2020
Publication title -
neurology and clinical neuroscience
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.125
0ISSN - 2049-4173
DOI - 10.1111/ncn3.12358
Subject(s) - medicine , leukoencephalopathy , neurocognitive , hypoxia (environmental) , autoantibody , pathophysiology , coma (optics) , anesthesia , antibody , pediatrics , pathology , immunology , psychiatry , cognition , disease , chemistry , physics , organic chemistry , oxygen , optics
Delayed post‐hypoxic leukoencephalopathy (DPHLE) is a rare demyelinating syndrome that follows an episode of prolonged cerebral hypoxia after a relatively lucid intervening period of variable length. Although the pathophysiology still remains obscure, it has been suggested that hypoxic‐metabolic injuries to oligodendrocytes may play a crucial role. We describe the case of a patient with chronic respiratory problems who fell into a coma during morphine therapy. After a brief period of successful recovery, neurocognitive and behavioral disorders suddenly appeared and a diagnosis of DPHLE was made also taking into account the MRI picture. The antioxidant therapy has probably facilitated the almost complete neurological recovery within 4 weeks. A peculiar finding was the presence of anti‐CV2/CRMP5 antibodies in serum, which may stand as potential factors implicated in oligodendrocytes damage.