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.

Delayed post‐hypoxic leukoencephalopathy with a peculiar autoantibody association

Coppola, Cinzia;Puoti, Gianfranco;Fratta, Mario;Ugga, Lorenzo;
2019

Abstract

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.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11591/421045
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