Victoria Schegerer

BACKGROUND: B-cell-depleting therapies are increasingly being used to treat autoimmune diseases. Although thousands of patients are and have been treated with these agents, the data are not yet strong enough to identify rare side effects with certainty. METHODS: We report the case of a patient undergoing ocrelizumab therapy for relapsing multiple sclerosis who developed a severe limbic syndrome. RESULTS: Autoimmune pathogenesis was initially suspected, with worsening on immunosuppressive therapy. Later, after diagnosis of an enterovirus infection, treatment with ribavirin and favipiravir in combination with intravenous immunoglobulins was initiated. After 4 weeks of therapy, the patient's clinical condition had stabilized with residual cognitive deficits. CONCLUSION: Diagnosis and treatment of enterovirus infections remain challenging, especially in patients receiving immunosuppressive therapy.

Recent years have seen a considerable increase in knowledge pertaining to Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD). Nevertheless, a noteworthy degree of uncertainty remains within the neurological community, primarily due to the often highly heterogeneous nature of the disease and the absence of approved long-term treatment options. In this article, we undertake a comprehensive review of the various treatment strategies and drug options available for the pharmacological treatment of acute attacks and relapses in MOGAD.

Background: Lumbar puncture (LP) is an essential tool in everyday clinical neuropsychiatric practice. It has been demonstrated that, among junior doctors, the procedure is associated with elevated levels of stress and anxiety, which can ultimately result in patient suffering. Notwithstanding the evident challenges, innovative teaching methodologies have not yet become a standard in daily clinical practice, despite the existence of different LP simulators. Methods: The prospective case-control study comprised 20 undergraduate medical students who participated in a tutorial that encompassed both theoretical knowledge and practical training regarding LP, utilizing a simulation model ("tutorial group"). Twenty-one students who were instructed in LP technique according to teaching methods from everyday clinical practice were used as controls ("control group"). A questionnaire was administered to all students, enquiring about confidence levels, theoretical knowledge, and their proficiency when handling the puncture needles. Moreover, the success rate in performing their initial 4 LPs was measured. Results: < 0.001). Furthermore, confidence levels and safety when handling the puncture needles were significantly higher in the tutorial group, as well as knowledge regarding theoretical backgrounds. Higher confidence and safety in needle handling were strongly associated with a higher success rate. Conclusion: Short simulator-based tutorials have been shown to be an effective method of increasing the skills of young physicians and students in LP, and thus enhancing patient safety. Analogous approaches should be implemented on a large scale in medical education.