Severe aseptic temporal lobe encephalitis on fingolimod.

Abstract

We report the case of an MS patient with aseptic temporal lobe encephalitis while on treatment with fingolimod. This 49-year-old woman developed headache and decreasing level of consciousness after 3.5 years of fingolimod therapy. Imaging, CSF studies, and rapid clinical response to acyclovir suggested a viral etiology, although CSF cultures and viral PCR were negative. This case illustrates the potential for severe manifestations of infectious illnesses on fingolimod, which may have a predilection for the CNS and also include herpes virus infections, cryptococcus, and PML. Efforts to prevent these secondary infections are limited by a lack of established risk factors.

• Authors: Dalia L Rotstein, Aditya Bharatha, Daniel Selchen
• Journal: Multiple sclerosis and related disorders (Mult Scler Relat Disord) Vol. 23 Pg. 4-6 (Jul 2018) ISSN: 2211-0356 [Electronic] Netherlands
• PMID: 29689473 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2018. Published by Elsevier B.V.

Chemical References

• Immunosuppressive Agents
• Fingolimod Hydrochloride

Topics

• Encephalitis (diagnostic imaging, drug therapy, etiology)
• Female
• Fingolimod Hydrochloride (adverse effects, therapeutic use)
• Humans
• Immunosuppressive Agents (adverse effects, therapeutic use)
• Middle Aged
• Temporal Lobe (diagnostic imaging)