- |||||||||| Imbruvica (ibrutinib) / AbbVie, J&J
CAR T Cells in Primary and Secondary CNS Lymphoma (Colorado Convention Center | Mile High 4CD) - Mar 8, 2024 - Abstract #AAN2024AAN_3861;
CD19-directed CAR T-cells exhibit promising anti-tumor effects and a favorable safety profile in patients with primary and secondary CNS lymphoma. Further evaluation on the optimal bridging regimens prior to CAR-T cells and corticosteroid use is warranted.
- |||||||||| albendazole / Generic mfg., praziquantel / Generic mfg., dexamethasone injection / Generic mfg.
Combination Therapy for Diffuse or Calcific Neurocysticercosis: A Proof-of-Concept Study (Colorado Convention Center | 708/710/712) - Mar 8, 2024 - Abstract #AAN2024AAN_3849;
Intravenous dexamethasone administered at a dosage of 0.2 mg/kg/body weight as a pretreatment and continued throughout the antiparasitic therapy...Starting with 200 mg albendazole, the dose was increased in 200 mg increments every three days until the targeted dose of 15 mg/kg/day. Praziquantel commenced at 300 mg and was increased by 300 mg every three days until a target dose of 50 mg/kg/day was achieved...Evidence-based guidelines and randomized controlled trials of the larger population are needed to test the safety and efficacy of this combination therapy
- |||||||||| Rituxan (rituximab) / Roche
Treatment of Hypertrophic Pachymeningitis: A Systematic Review (Colorado Convention Center | Exhibit Hall B-E) - Mar 8, 2024 - Abstract #AAN2024AAN_3772;
The diagnosis of HP still presents a major challenge, as does the etiological investigation, which defines the treatment. It is essential that experiences between services around the world are exchanged, with the aim of improving the study of basic conditions, in addition to the results obtained with the treatment proposed in each clinical situation.
- |||||||||| cyclophosphamide / Generic mfg., methylprednisolone sodium succinate / Generic mfg.
Acute Disseminated Encephalomyelitis (ADEM) Presenting as Neuroleptic Malignant Syndrome (NMS) (Colorado Convention Center | Exhibit Hall B-E) - Mar 8, 2024 - Abstract #AAN2024AAN_3769;
Despite limited evidence presently, prognosis seems promising with immunomodulating treatments, given success of treatment with IV methylprednisolone with IVIG in our case and IV methylprednisolone with IV cyclophosphamide by Delgado et. al.
- |||||||||| Rituxan (rituximab) / Roche
Recurrent Tumefactive Demyelination and HIV - Case Report and Long-term Follow-up (Colorado Convention Center | Exhibit Hall B-E) - Mar 8, 2024 - Abstract #AAN2024AAN_3766;
al. Treatment with IV methylprednisolone (IVMP) 1 g for 5 days followed by oral prednisone taper lead to improved.In April 2020, he experienced dizziness and worsening left-side weakness, along with a new cerebellar lesion...He has remained stable for over 2 years on rituximab and prednisone has been tapered to 10 mg daily...NA
- |||||||||| dexamethasone / Generic mfg., gabapentin / Generic mfg.
Hematomyelia due to Thoracic Arteriovenous Malformation in Patient with Klippel-Trenaunay Syndrome (Colorado Convention Center | Exhibit Hall B-E) - Mar 8, 2024 - Abstract #AAN2024AAN_3697;
There is limited literature on acute myelopathy due to vascular lesions in patients with known vascular malformation syndromes such as KTS, Parkes-Weber Syndrome, and CLOVES. This case highlights the significance of early consideration of acute hematomyelia due to AVMs to allow for timely neurosurgical intervention and prevention of complications such as permanent paresis.
- |||||||||| methylprednisolone sodium succinate / Generic mfg.
Idiopathic CD4+ Lymphocytopenia: A Rare and Often Overlooked Immunocompromising Factor for PML (Colorado Convention Center | Exhibit Hall B-E) - Mar 8, 2024 - Abstract #AAN2024AAN_3691;
Idiopathic CD4+ T lymphocytopenia (ICL) is defined as a CD4 count <300 cells/mcL or <20% without HIV infection. This case underscores the importance of checking the CD4 count in suspected PML cases, even when HIV is negative.
- |||||||||| Rituxan (rituximab) / Roche
Late-onset Anti-NMDAr Encephalitis After HSV Encephalitis in Pregnancy (Colorado Convention Center | Exhibit Hall B-E) - Mar 8, 2024 - Abstract #AAN2024AAN_3559;
Although post-infectious anti-NMDAr encephalitis typically presents within a few weeks following HSVE, delayed presentation is still a possibility and must be considered. Furthermore, HSV infection may trigger in these patients a persistent autoimmune activation, as opposed to classic anti-NMDAr encephalitis which is more often monophasic.
- |||||||||| prednisone / Generic mfg., levetiracetam / Generic mfg., methylprednisolone sodium succinate / Generic mfg.
Non-convulsive Status Epilepticus due to LGI-1 Encephalitis Presenting as Intermittent Confusion (Colorado Convention Center | Exhibit Hall B-E) - Mar 8, 2024 - Abstract #AAN2024AAN_3555;
It is critical to consider possible autoimmune encephalitis in patients with subacute onset of memory deficits, unexplained seizures, CSF pleocytosis or MRI features suggestive of encephalitis and reasonable exclusion of alternative etiologies. Prompt empiric treatment based on clinical features can improve outcomes and prevent serious sequala.
- |||||||||| Rituxan (rituximab) / Roche
NMDA Receptor Encephalitis in a Transgender Patient: A Case Report and Literature Review (Colorado Convention Center | Exhibit Hall B-E) - Mar 8, 2024 - Abstract #AAN2024AAN_3554;
Males with NDMAR encephalitis typically present with partial seizures followed by cognitive symptoms compared to females who first present with behavioral symptoms.2 Our patient presented with behavioral symptoms similar to females. Estrogen mediates NMDAR conductance3 and inhibits GABA transmission, which propagates neuronal dendritic spines,4 increasing seizure susceptibility.
- |||||||||| Keytruda (pembrolizumab) / Merck (MSD)
Acute Autoimmune Limbic Encephalitis Associated with GABABR Antibody in a Patient with Advanced Squamous Cell Carcinoma of the Cervix Treated with Pembrolizumab: A Case Report (Colorado Convention Center | Exhibit Hall B-E) - Mar 8, 2024 - Abstract #AAN2024AAN_3551;
Our case demonstrated the rare occurrence of autoimmune limbic encephalitis in case of cervical squamous cancer with GABABR, neuronal surface receptor, antibody-mediated CNS inflammation presenting with seizures, encephalopathy status post immunotherapy with pembrolizumab, an immune checkpoint inhibitor. Anti-GABABR antibody mediated limbic encephalitis is uncommon but potentially treatable condition and should be in differential diagnosis of patients presenting with new-onset seizures, refractory seizures, memory loss, and altered mental status in context of cancer or should be evaluated thoroughly for underlying cancer if presented with limbic encephalitis; early diagnosis and prompt treatment are vital for better outcomes.
- |||||||||| Blincyto (blinatumomab) / Astellas, Amgen
An Interesting Presentation of a Blinatumomab-associated Neurological Event (Colorado Convention Center | Exhibit Hall B-E) - Mar 8, 2024 - Abstract #AAN2024AAN_3507;
Ir-AEs include headache, seizures, aphasia, and encephalopathy and are typically managed with infusion interruptions or dexamethasone therapy.Design/Case reportA 39-year-old lady undergoing in-hospital chemotherapy for ALL developed acute onset of global aphasia and right facial droop on day 28 of treatment with blinatumomab prompting activation of a stroke alert...While blinatumomab-induced neurotoxicity was amongst the differentials, due to the focal neurological findings, risk for permanent disability and concern for an acute ischemic stroke, the patient received intravenous therapy with alteplase...An acute neurological change in a patient requires rapid triage and time-sensitive decision making. In patients with cancer who are on immunotherapy with agents such as Blinatumomab, the differentiation of etiologies such as stroke and stroke mimics can be challenging as many of the symptoms of neurologic ir-AEs of Blinatumomab can mimic CVD.
- |||||||||| Kineret (anakinra) / SOBI, Tecvayli (teclistamab-cqyv) / Genmab, J&J
Managing Neurotoxicity in B-cell Maturation Antigen (BCMA)-directed Therapy: A Case-series Study (Colorado Convention Center | Exhibit Hall B-E) - Mar 8, 2024 - Abstract #AAN2024AAN_3506;
Despite employing a range of interventions, disease progression was observed, ultimately resulting in the death of both patients. It's vital to highlight that, in both of these patients, despite experiencing severe ICANS, imaging did not reveal any abnormalities.
- |||||||||| Rituxan (rituximab) / Roche
Optic Neuritis in a Case of Secondary Hemophagocytic Lymphohistocytosis (Colorado Convention Center | Exhibit Hall B-E) - Mar 8, 2024 - Abstract #AAN2024AAN_3489;
There was an improvement in paresthesia symptoms and ocular pain but visual acuity remained unchanged.Patient was started on a single course of rituximab before being readmitted for pneumonia and neutropenic fever...HLH is a rare, rapidly progressive, systemic inflammatory syndrome that can present at any age with unexplained neurological symptoms. Certain genetic mutations in combination with a high index of suspicion can aid in timely diagnosis and treatment.
- |||||||||| methotrexate / Generic mfg.
Cough-headache as a Novel Presentation of Methotrexate Neurotoxicity (Colorado Convention Center | Exhibit Hall B-E) - Mar 8, 2024 - Abstract #AAN2024AAN_3488;
Patients receiving high-dose or intrathecal MTX are also at high risk of spontaneous intracerebral hemorrhage which should first be ruled out. Following initial imaging, MTX neurotoxicity should be considered in the differential with appropriate imaging ordered to evaluate for its presence.
- |||||||||| methylprednisolone sodium succinate / Generic mfg.
First Case of Optic Nerve Cavernoma in the United States Hispanic Population (Colorado Convention Center | Exhibit Hall B-E) - Mar 8, 2024 - Abstract #AAN2024AAN_3457;
Due to initial concern for optic neuritis, IV methylprednisolone was started, without response...While mostly CCMs are sporadic, its AD familial form can be caused by mutations in several genes including CCM1/KRIT1. In Hispanic Americans KRIT1 mutation is responsible for the disease process and this is the first case of optic nerve cavernoma in this population.
- |||||||||| ethambutol / Generic mfg.
Unmasking NMOSD: A Case of Misdiagnosed Ethambutol-Induced Optic Neuropathy (Colorado Convention Center | Exhibit Hall B-E) - Mar 8, 2024 - Abstract #AAN2024AAN_3344;
This impairment arose after the initiation of triple therapy with rifampin, azithromycin, and ethambutol for her nontuberculous Mycobacterium kansasii infection...This case highlights the intricacies involved in diagnosing NMOSD, especially in individuals with multiple coexisting health issues. It underscores the necessity of an all-encompassing diagnostic approach, incorporating specific laboratory and imaging assessments, to ensure precise diagnosis and appropriate therapeutic interventions.
- |||||||||| rivaroxaban / Generic mfg., prednisone / Generic mfg., methylprednisolone sodium succinate / Generic mfg.
A Case of MOG-AD in an 89-year-old Male (Colorado Convention Center | Exhibit Hall B-E) - Mar 8, 2024 - Abstract #AAN2024AAN_3340;
The patient was diagnosed with MOGAD and started on IV Methylprednisolone followed by a Prednisone taper with improvement. MOGAD should be considered on the differential for thoracic myelopathy, when the clinical features, imaging and CSF findings are suggestive of this diagnosis even in older patients outside the typical age range for this disease.
- |||||||||| methylprednisolone sodium succinate / Generic mfg.
PBC-like Variant of GBS Associated with CAR-T Therapy (Colorado Convention Center | Exhibit Hall B-E) - Mar 8, 2024 - Abstract #AAN2024AAN_3319;
Some exhibit positive anti-GT1a antibodies and ganglioside antibodies may be negative. This is the first reported case of a PBC variant of GBS post CAR T-cell therapy.
- |||||||||| methylprednisolone sodium succinate / Generic mfg.
Intramedullary Spinal Cord Cavernous Malformation Presenting After Strenuous Weightlifting (Colorado Convention Center | Exhibit Hall B-E) - Mar 8, 2024 - Abstract #AAN2024AAN_3294;
Due to initial concern for transverse myelitis, the patient was treated empirically with IV methylprednisolone, without improvement, and a lumbar puncture was completed...Spinal cord cavernomas can present with acute hemorrhage after strenuous weightlifting. This should be considered in the differential when presented with signs and symptoms of transverse myelitis.
- |||||||||| cyclophosphamide / Generic mfg., methylprednisolone sodium succinate / Generic mfg.
A Case of Bilateral Strokes Caused by Vasculitic Intracranial Narrowings (Colorado Convention Center | Exhibit Hall B-E) - Mar 8, 2024 - Abstract #AAN2024AAN_3291;
Patient was started on IV Solumedrol for suspected CNS vasculitis and temporal biopsy was performed. This case demonstrated favourable outcomes and opens the door for future research investigating invasive treatment in CNS stenosing vasculitis related stroke.
- |||||||||| prednisone / Generic mfg., methylprednisolone sodium succinate / Generic mfg.
Giant Cell Arteritis with Bilateral Temporal Arteritis and Optic Perineuritis (Colorado Convention Center | Exhibit Hall B-E) - Mar 8, 2024 - Abstract #AAN2024AAN_3262;
It is typically associated with autoimmune conditions and rarely vasculitic diseases. This case highlights key clinical, radiographic, and pathologic features that led to the timely diagnosis and treatment of GCA.
- |||||||||| Rituxan (rituximab) / Roche
Autoimmune Glial Fibrillary Acidic Protein Astrocytopathy Associated with Rhabdomyolysis: A Case Report (Colorado Convention Center | Exhibit Hall B-E) - Mar 8, 2024 - Abstract #AAN2024AAN_3145;
Across two fixed-dose trials of patients with agitation associated with dementia due to AD, a greater proportion of patients treated with brexpiprazole 2 or 3 mg/day versus placebo achieved pre-defined criteria for agitation response. This case illustrates a unique manifestation of GFAP astrocytopathy including subacute visual loss followed with severe weakness, areflexia and rhabdomyolysis.
- |||||||||| mycophenolate mofetil / Generic mfg., methylprednisolone sodium succinate / Generic mfg.
A Case of Anti-Glial Fibrillary Acidic Protein (GFAP) Antibody-associated Arachnoiditis Presenting as Cauda Equina Syndrome (Colorado Convention Center | Exhibit Hall B-E) - Mar 8, 2024 - Abstract #AAN2024AAN_3144;
Patient was treated with 1gm IV Methylprednisolone for 5 days and had significant improvement- able to walk without support. Autoimmune GFAP Astrocytopathy can also present as Arachnoiditis.It will be worthwhile to look for CSFAnti-Glial Fibrillary Acidic Protein (GFAP) antibody as it a treatable condition which responds to Immunotherapy.
- |||||||||| methylprednisolone sodium succinate / Generic mfg.
A Case of Septin-7 Antibody-associated Encephalitis Associated with Seizures and Squamous Cell Lung Carcinoma (Colorado Convention Center | Exhibit Hall B-E) - Mar 8, 2024 - Abstract #AAN2024AAN_3142;
The full clinical and paraneoplastic spectrum of septin-7 IgG-associated central nervous system disorders is not yet fully defined. Our case highlights that presence of septin-7 IgG may be associated with squamous cell lung carcinoma, and seizures may be within the clinical phenotype.
- |||||||||| methylprednisolone sodium succinate / Generic mfg.
Locked in Syndrome Due to Powassan Virus (Colorado Convention Center | Exhibit Hall B-E) - Mar 8, 2024 - Abstract #AAN2024AAN_3068;
While our patient demonstrated many of the typical neurological sequelae observed in Powassan patients, a unique outcome in his case was development of "locked-in" syndrome. This is the only reported case of Powassan virus that progressed to 'locked-in' syndrome.
- |||||||||| methylprednisolone sodium succinate / Generic mfg.
Characterizing Monomelic Presentations of Demyelinating Neuropathy, or "Chronic Inflammatory Demyelinating Mononeuropathy" (CIDM) (Colorado Convention Center | Bluebird 2E-H) - Mar 8, 2024 - Abstract #AAN2024AAN_2894;
CIDM presents as a focal inflammatory demyelinating neuropathy that is difficult to diagnose as most cases (63%) do not meet CIDP electrophysiological criteria and only have mild elevation of CSF protein. Our study shows that focal CIDP usually remains localized (74%) over many years, is responsive to immunotherapy, and is hard to diagnose, making the use of MRI and targeted nerve biopsy important tools in its evaluation.
- |||||||||| thalidomide / Generic mfg., dexamethasone injection / Generic mfg.
Optochiasmatic Arachnoiditis - A Devastating Complication of Tuberculous Meningitis (Colorado Convention Center | Exhibit Hall B-E) - Mar 8, 2024 - Abstract #AAN2024AAN_2798;
A clinical diagnosis of TB meningitis was made, and treatment with standard Anti TB chemotherapy and IV dexamethasone was commenced.Two months later, the patient complained a persistent headache with deteriorating visual acuity in his right eye and a temporal field defect in his left eye...Due to the suspicion of a paradoxical reaction, his immunosuppression was intensified with the addition of Thalidomide. This case aims to highlight OCA as a complication of TBM and the therapeutic challenges associated with it.
- |||||||||| Actemra IV (tocilizumab) / Roche, JW Pharma, Rituxan (rituximab) / Roche
Novel Observations in the Management of Relapsing Non-syndromic Pediatric Tumefactive Demyelinating Lesions (Colorado Convention Center | Exhibit Hall B-E) - Mar 8, 2024 - Abstract #AAN2024AAN_2740;
However, our first two patients had multiple subsequent relapses characterized by new focal symptoms including seizures, motor weakness, diplopia, and cranial nerve palsies associated with the appearance of larger existing TDLs and new discrete TDLs despite long term IVIG therapy and initiating rituximab, even more than a year later...Therefore, treatment was escalated to tocilizumab with sustained remission since its initiation in both patients...Nonsyndromic relapsing TDLs are diagnostic conundrums that can cause significant neurological sequelae. Therefore, better characterization of these patients is critical to guide effective treatment.
- |||||||||| levetiracetam / Generic mfg., methylprednisolone sodium succinate / Generic mfg.
Hu Would Have Thought, Eh? An Interesting Case of Temporal Lobe Epilepsy in an Elderly Patient (Colorado Convention Center | Exhibit Hall B-E) - Mar 8, 2024 - Abstract #AAN2024AAN_2613;
It also shows an unexpectedly good clinical and electrographic response to immunosuppression. Finally, we appreciated how the EEG was used as an objective marker of improvement in a patient recovering from limbic encephalitis.
- |||||||||| Humira (adalimumab) / AbbVie
What's that Mass? A Sphenoid Lesion Causing Cavernous Sinus Syndrome (Colorado Convention Center | Exhibit Hall B-E) - Mar 8, 2024 - Abstract #AAN2024AAN_2612;
She has since been stable on adalimumab.Neurosarcoidosis is a diagnosis of exclusion, and a systematic workup is crucial to ensure prompt, proper treatment. It is important for neurology providers to recognize presentation and exam findings for a cavernous sinus mass, understand differential diagnoses and workup for said mass, and be able to facilitate acute and long-term management of neurosarcoidosis.
- |||||||||| Keytruda (pembrolizumab) / Merck (MSD), Avastin (bevacizumab) / Roche
Successful Treatment of Immune Checkpoint Inhibitor Induced Optic Neuritis (Colorado Convention Center | Exhibit Hall B-E) - Mar 8, 2024 - Abstract #AAN2024AAN_2607;
Our case study provides evidence for a tremendous recovery with PLEX for pembrolizumab-associated optic neuritis. Aggressive acute initial management of ICI-related complications should be considered, especially in cases of increased morbidity and mortality.
- |||||||||| Safety of CAR T-Cell Therapy in Patients with Active Autoimmune Diseases: A Case Report (Colorado Convention Center | Exhibit Hall B-E) - Mar 8, 2024 - Abstract #AAN2024AAN_2606;
Ultimately, she proceeded with lisocabtagene maraleucel (liso-cel) CAR-T. She had CRS grade 1 (fever) treated with tocilizumab and dexamethasone...We hope that our experience might open the discussion for broader use of CAR-T in oncology patients with autoimmune and paraneoplastic syndromes.
- |||||||||| methylprednisolone sodium succinate / Generic mfg.
Acute Motor and Sensory Axonal Neuropathy (AMSAN) Relapse After COVID-19 Infection: A Case Report and Literature Review (Colorado Convention Center | Exhibit Hall B-E) - Mar 8, 2024 - Abstract #AAN2024AAN_2546;
High dose intravenous methylprednisolone (IVMP) was started, and the patient was discharged with partial improvement...The development of worsening weakness after a COVID-19 infection and axonal findings of EMG should alert the clinician about the possibility of AMSAN or GBS variants. Relapse of symptoms should be considered.
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