Anti-N-Methyl-D-Aspartate Receptor Encephalitis Triggered by Lyme Disease
Notice bibliographique
Résumé
A 70-year-old man presented with a complete right facial nerve palsy.Past medical history was only remarkable for hypertension and gastroesophageal reflux disease.He was diagnosed with an idiopathic Bell's palsy, for which he was treated with a course of prednisone and valacyclovir.He had complete resolution of facial weakness within 3 weeks of symptom onset.Four weeks after initial symptom onset, however, he became agitated and began exhibiting bizarre behavior, including inappropriately raising his voice at people and urinating on the side of the road.He then reportedly acutely developed incoherence and bilateral arm weakness, leading to local hospital admission.Head computed tomography (CT) was unremarkable, and his acute symptomology subsided so he was discharged back home.However, his family noted that he was repetitive and continued to have bizarre behavior.Over the next 3 weeks, he had four visits to the emergency room because of aggressive outbursts, such as yelling, pushing people, and hitting his own head.He was described as having pressured speech and was pacing the room.In addition, he also complained of headache.He had remained afebrile throughout these presentations.Unenhanced head magnetic resonance imaging (MRI) and routine electroencephalography (EEG) were unremarkable.For his agitation, he was initially prescribed lorazepam and sertraline and then switched to quetiapine, without significant response.On his fourth admission, he had severe agitation requiring fourpoint restraints and treatment with haloperidol.He was assessed by the Neurology service, and aside from his behavioral change his examination including vital signs, orientation, cranial nerves, motor function, reflexes, sensation, and coordination were grossly intact.Formal bedside cognitive testing was not performed.Metabolic workup, including thyroid-stimulating hormone, vitamin B 12 , liver function, and electrolytes, were normal, except for mildly elevated creatinine at 117 micromoles per liter.Rheumatologic workup only revealed a positive antinuclear antibody (ANA) at a titer of 1:80 with speckled pattern but was otherwise negative for extractable nuclear antigen, antimicrosomal antibodies, and anti-neutrophil cytoplasmic antibody.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».