Clinical-Medical Image - International Journal of Clinical & Medical Images (2022) Volume 9, Issue 6
Author(s): Douglas R. Nordli III, Chethan K. Rao, Vincent Gonzalez, Loren McLendon and Fernando Galan
A 16-year-old previously-healthy young man presented to the pediatric emergency department with 5 weeks of stepwise neurologic complaints: orobuccal weakness followed by diplopia, dysarthria, and impaired coordination. His neurologic exam showed left appendicular ataxia, right ptosis, and right hemifacial plegia. Empiric immunotherapy trial with glucocorticoids yielded minimal symptomatic improvement and autoimmune testing was negative. Temporal biopsy confirmed diffuse high-grade H3- and IDH-wild-type glioma. Gliomatosis cerebri is a growth pattern by definition involving three or more lobes of the brain [1,2]. Imaging can resemble cortical encephalitis and may not show contrast enhancement [1,2]. A lack of response to conventional immunotherapy should raise concerns for gliomatosis cerebri in pediatric patients being treated for autoimmune encephalitis [1,2] (Figures 1 and 2).
No funding was secured for this study.
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