Table 1.

CSF and serum profile of the patient on admission, after starting administration of antineurobrucellosis (ANB) treatment and after receiving rituximab.

	ICU admission	First course γ-globulin, methylprednizolone ANB therapy 10th day ICU	Second course γ-globulin, diazepam ANB therapy 63th day ICU	Third course γ-globulin, diazepam, baclofen ANB therapy 75th day ICU	First course of 2 gr rituximab ANB therapy 5 months ICU	Second course of 2 gr rituximab ANB therapy 8 months ICU	Third course of 2 gr rituximab ANB therapy 12 months ICU
CSF cells/mm3 (lymphocytes)	39	184	21	–	1	2	N/A
CSF proteins (mg/dl)	65	45	43	–	50	34	N/A
CSF GlyR anti-	N/A	+++ (1:20)	++ (1:20)	+ (1:20)	NEG (1:20)	NEG (1:20)	N/A
Serum GlyR anti-	N/A	++ (1:40)	++ (1:40)	++ (1:40)	+ (1:40)	+ (1:40)	N/A
Othalmoplegia	Yes	Yes	No	No	No	No	No
Hyperidrosis	Yes	Severe	Severe	Severe	Severe	Less	None
Myoclonus	Severe	Severe	Severe	Less	Less	None	None
Diplopia	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Startle –panic attacks	No	No	Yes	Yes	Yes	Less	No
Respiratory spasms bradycardia	No	No	Yes	Yes	No	No	No

The fourth column represents the status of the patient just before the introduction of rituximab and while on ABN treatment. After the 3rd course of rituximab, muscle and respiratory spasms, hyperidrosis, panic attacks and episodes of bradycardia completely disappeared. Stiffness slightly improved.

CSF, cerebrospinal fluid; GlyR, glycine receptors; ICU, intensive care unit; N/A, not available; NEG, negative; POS, positive.