Figure 1

(A) Laboratory values. Normal ranges: C-reactive protein (CRP), <5 mg/L; alanine aminotransferase (ALAT), <0.75 microkat/L. (B) Clinical course and treatment. ICU; admission to intensive care unit. Prednisone was administered at 80 mg/day (starting at Week 3) and later adjusted to 60 mg/day in a lowering dose until complete drug withdrawal. Ganciclovir was started at Week 6 at 5 mg/kg per day. Antivirals were administered consecutively for 5 months, while IVIg (0.4 g/kg/day on 5 days) was administered on a three week-basis. (C) and (D) Imaging findings. Twenty days after disease onset, T2-weighted MRI scans showed increased signal in the pons (arrowheads), mesencephalon, globus pallidus, and external capsula while six months later (D) complete regression of the signal enhancement (arrowheads) and an intact blood–brain barrier were observed.