Postinfectious Immune-Mediated Neurological Diseases

Abstract

Infection may trigger immune-mediated neurological dysfunction. In some specific examples, the pathogenesis has been clearly delineated, with a detrimental effect of the immune response to infection. This chapter will cover immune-mediated neurological diseases where infection is the antigenic trigger. Postinfectious cerebellitis, Miller Fisher syndrome, acute disseminated encephalomyelitis, vasculitis and Guillain-Barré syndrome (GBS) are discussed, from the clinical presentation to therapies. Presentation may be monophasic (e.g. GBS) or sometimes evolve into a chronic condition (e.g. vasculitis). In some cases, the prognosis is excellent with full recovery. In others, patients will develop permanent neurological deficits. Therapies are often based on steroids, plasma exchange and intravenous immunoglobulins. Despite a favourable clinical course, postinfectious cerebellitis may rarely require surgical decompression due to oedema of the posterior fossa. Treatment should be initiated as fast as possible.