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By J. McCann

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Extra resources for Critical Care Challenges - Disorders, Treatments, Procedures

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A P SYC H OT I C B R E A K A N D S E I ZU R E S 45 Specific treatment is based on disabling antibodies through immunosuppression and knocking out production with treatment of the underlying malignancy. First-​line immunosuppression in these critically ill adults is usually high-​dose IV methylprednisolone and either IV immunoglobulin (IVIG) or plasma exchange. Rituximab and cyclophosphamide are considered second-​ line agents when there is an insufficient response to first-​line treatments. Early treatment speeds recovery, reduces neurological disability, and decreases relapses.

2009;84:403– ​4 09. Brouwer MC, Heckenberg SGB, de Gans J, et al. Nationwide implementation of adjunctive dexamethasone therapy for pneumococcal meningitis. Neurology. 2010;75:1533–​1539. Brouwer MC, Wijdicks EFM, van de Beek D. What is new in bacterial meningitis? Intensive Care Med. 2016;42:415–417. Kasanmoentalib ES, Brouwer MC, van der Ende A, van de Beek D. Hydrocephalus in adults with community-​acquired bacterial meningitis. Neurology. 2010;75:918–​923. Kim KS. Acute bacterial meningitis in infants and children.

2008;28:511– ​522. McGrath N, Anderson NE, Croxson MC, Powell KF. Herpes simplex encephalitis treated with acyclovir: diagnosis and long term outcome. J Neurol Neurosurg Psychiatry. 1997;63:321–​326. Rosenfield MR, Dalmau J. Update on paraneoplastic and autoimmune disorders of the central nervous system. Semin Neurol. 2010;30:320–​3 33. Singh TD, Fugate JE, Rabinstein AA. The spectrum of acute encephalitis: causes, management, and predictors of outcome. Neurology. 2015;84:359–​3 66. Steiner I, Budka H, Chaudhuri A, Koskiniemi M, Sainio K, Salonen O, Kennedy PG.

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