XXXX without predisposing illness--a review of 83 cases.

@entity1 @entity2379 @entity5 @entity693 @entity1906 @entity1328 @entity230 @entity378 @entity413 @entity3554 @entity288
Eighty-three previously healthy @entity1 with @entity693 presenting to a general hospital were reviewed. The single most common cause was @entity378 (40 per cent) with @entity1328 (7 per cent), @entity5 (8 per cent) and other definable causes much less frequent. In one-third of @entity1 (34 per cent) no cause was found although most appeared to respond to treatment either with anti- @entity378 drugs or @entity230 . There were some differences in clinical presentation, the clinical picture being most characteristic in @entity1906 and @entity3554 . However, there were frequent exceptions to any general rule and, particularly in adults, the clinical features and changes in cell count, protein and @entity413 in the cerebrospinal fluid (CSF) did not reliably distinguish one form of @entity693 from another. Cerebral and meningeal biopsy produced disappointing results with respect to practical guidance in management. It is often necessary to begin treatment before a cause has been identified. Important points in management include the early use of anti- @entity378 treatment and the difficulty in deciding on a trial of treatment with @entity288 or @entity2379 . Not emphasised in previous reports is a subgroup of @entity1 with @entity693 who are responsive to treatment with @entity230 . Those @entity1 tend to follow a more prolonged indolent course and often require long-term immunosuppression to control symptoms.
