Some time ago, passers-by noticed a woman on the street. She tried to unlock other people’s bikes. Those passing by noticed that the woman was not completely conscious and called an ambulance. The middle-aged patient came to our clinic disoriented and feverish. After a short time she suffered a series of epileptic seizures, with short, rapid muscle twitches in her face. In order to rule out bleeding in the brain or a tumor, the colleagues in the rescue center did a computer tomography. She was unremarkable. Examination of blood and cerebrospinal fluid revealed an increased number of white blood cells. Had viruses or bacteria attacked the brain? That would explain the fever, confusion and signs of inflammation.
Because a situation like this can quickly become life-threatening, we began treatment without a clear diagnosis. We gave a drug that was supposed to stop the multiplication of herpes viruses. The patient also received two different antibiotics against a possible bacterial infection. We then did an MRI scan: The cerebral cortex, the outermost area of the brain that is responsible for cognitive functions such as language and voluntary decisions, looked thickened and lumpy in the images. Something like this happens during inflammation, when fluid and inflammatory cells penetrate the brain tissue.
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