PMC9909330_01
Magnetic resonance imaging of the brain before immunotherapy. The left frontal lobe showed abnormal (A) T1 hypointensity, (B) T2 hyperintensity, (C) hyperintensity on fluid-attenuated inversion recovery imaging, (D) restricted diffusion and (E) decreased cerebral blood flow. (F) This lesion showed gyral enhancement involving the cortex and subcortical white matter.
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The patient underwent brain MRI, showing abnormal hypointensity in the left frontal lobe on a T1 sequence, hyperintensity on T2 and fluid-attenuated inversion recovery sequences, restricted diffusion, and decreased cerebral blood flow ( Figure 1 ).
Magnetic resonance imaging of the brain one month after immunotherapy. The left frontal lobe showed abnormal (A) T1 hypointensity, high-low mixed sign on T2 imaging (B) and on fluid-attenuated inversion recovery imaging (C). (D) This lesion showed gyral and patchy enhancement involving the cortex and subcortical white matter.
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MRI one month after initiation of immunotherapy showed a markedly smaller frontal lobe lesion than before therapy ( Figure 2 ).
Timeline of the patient's episodes and interventions. Day 1 refers to the day of admission to our emergency department. CASPR2, contactin-associated protein-like 2; IVIg, intravenous immunoglobulin.
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The timeline of the patient with relevant data regarding the episodes and interventions is presented in  Figure 3 .