case_images: PMC5744188_01
case_images: (A) MRI shows pontocerebellar lesion with incomplete peripheral enhancement. (B) Elevated IFNgamma response against neurofascin (NF)155 and NF186 before clinical manifestation in Elispot assay. (C) Follow-up MRI shows new lesion in the middle cerebellar peduncle and adjacent pons without clinical manifestation or contrast enhancement. (D) Follow-up Elispot assay shows no IFNgamma response against NF.
case_images: fneur-08-00724-g001.jpg
case_images: PMC5744188_01_fneur-08-00724-g001.jpg
case_images: F1
case_images: There was no concurrent pathological meningeal enhancement (Figure 1A). IFN-gamma spots/106 MNCs) compared to CEF peptide pool specific IFN-gamma response (1,062 IFN-gamma spots/106 MNCs) by ELISPOT assay (Figure 1B). In comparison, 16 patients with non-immune neuropathy revealed no NF155 (mean 0.5 IFN-gamma spots/106 MNCs) and NF186 (mean 0 IFN-gamma spots/106 MNCs) with CEF peptide pool specific IFN-gamma response (519 IFN-gamma spots/106 MNCs). Interestingly, NF155 as well as NF186 antibodies measured by ELISA according to the protocol of Ng et al. were negative. Follow-up MRI scan 18 months later revealed a new, non-enhancing lesion within the middle cerebellar peduncle and the adjacent pons, the previously diagnosed lesion was not did no longer show gadolinium enhancement (Figure 1C). Figure 1D). NF-specific antibodies remained negative. Follow-up CSF remained unchanged with a mild pleocytosis and elevated protein (129 mg/dl) without OCB.