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Reversible dementia with idiopathic hypereosinophilic syndrome

Department of Neurology, Francis Scott Key Medical Center and The Johns Hopkins University School of Medicine (Drs. Kaplan, Kawas, and Bolla-Wilson)
Department of Medicine, Francis Scott Key Medical Center and The Johns Hopkins University School of Medicine, Baltimore, MD (Dr. Waterbury)
Department of Medicine, Duke University Medical Center, Durham, NC. (Dr. Durack)

A 66-year-old woman with hypereosinophilic syndrome became rapidly demented. Evaluation revealed CSF eosinophilia, background slowing on EEG, and periventricular MRI abnormalities. Following steroid therapy, there was rapid resolution of the dementia and normalization of CSF and EEG. These findings support the concept of a direct neurotoxic effect on the human CNS produced either by eosinophils or possibly by eosinophil-derived neurotoxins.

Address correspondence and reprint requests to Dr. Kaplan, Department of Neurology, Francis Scott Key Medical Center, 4940 Eastern Avenue, Baltimore, MD 21224.

Received November 29, 1988. Accepted for publication in final form April 17, 1989.

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