Granulomatous Meningoencephalitis - Types of GME

Types of GME

  • Disseminated - This is a diffuse disease throughout the CNS. It was previously known as inflammatory reticulosis. There is an accumulation of mononuclear cells and neutrophils around the blood vessels (perivascular) of the CNS. Meningitis is seen with this form of GME and causes fever and neck pain. It has an acute progression over a few weeks. Symptoms include incoordination, nystagmus, head tilt, seizures, and depression.
  • Focal - The disease presents as a granuloma, which mimics a tumor. It usually is found in the cerebrum or cerebellopontine angle. Symptoms may be acute or develop slowly over several months and depend on the location of the lesion.
  • Ocular - This is an uncommon form of GME and is characterized by sudden blindness caused by optic neuritis. The disease is bilateral. Ocular GME is considered to be an extension of CNS disease. The blood vessels of the posterior segment of the eye and anterior uvea have the same infiltrates of inflammatory cells as the intracranial vessels. Uveitis, retinal detachment, and secondary glaucoma may be seen.

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