Unilateral cortical FLAIR-hyperintense Lesion in Anti-MOG-associated Encephalitis with Seizures (FLAMES) on TNF inhibitor therapy
Bibliographic record
Abstract
A 34-year-old man presented with new-onset right-sided headache, episodic visuospatial disorientation and episodic photopsia in his left visual field. His medical history was significant for ulcerative colitis, well-controlled on infliximab 450 mg intravenous every 8 weeks which he had been receiving for the past 10 years. On brain MRI, T1-weighted post-gadolinium imaging revealed right inferior parietal and occipital leptomeningeal enhancement (figure 1A, white circle), with corresponding gyral and sulcal hyperintensity on T2-fluid attenuated inversion recovery (FLAIR) imaging (figure 1B, white circle). No abnormality was seen on T2-weighted or diffusion-weighted imaging (not shown). We suspected focal meningo-encephalitis. Given the concern for an inflammatory central nervous system (CNS) event, infliximab was discontinued. He was trialled on levetiracetam 250 mg PO two times per day for possible focal-onset seizures, but had ongoing episodic photopsia followed by left-sided visual loss 2 weeks later. Neurological examination showed left-sided homonymous hemianopsia. Repeat brain MRI revealed progression of T2-FLAIR hyperintensity involving the right parietal and occipital lobes, with extension to the splenium of the corpus callosum (figure 1C1,C2) and persistent leptomeningeal enhancement (not shown). Repeated cerebrospinal fluid (CSF) …
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".