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The initial suspected diagnosis of TBE was confirmed after a significant diagnostic delay, likely caused by negative serological testing due to B-cell depletion from ocrelizumab treatment for underlying MS. TBE diagnosis was made using polymerase chain reaction (PCR) and oligo-hybrid capture metagenomic next-generation sequencing (mNGS) of cerebral spinal fluid and brain biopsy samples which yielded a near-full length TBE Virus (TBEV) genome.<\/jats:p>","DOI":"10.1177\/13524585251369425","type":"journal-article","created":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T08:51:21Z","timestamp":1757580681000},"page":"652-655","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Severe course of tick-borne encephalitis (TBE) in a patient with relapsing multiple sclerosis (MS) treated with ocrelizumab"],"prefix":"10.1177","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6655-5557","authenticated-orcid":false,"given":"Jonathan A","family":"Gernert","sequence":"first","affiliation":[{"name":"Institute of Clinical Neuroimmunology, LMU University Hospital, LMU Munich, Munich, Germany; Department of Neurology with Friedrich Baur Institute, LMU University Hospital, LMU Munich, Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias","family":"Klein","sequence":"additional","affiliation":[{"name":"Department of Neurology with Friedrich Baur Institute, LMU University Hospital, LMU Munich, Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florian","family":"Sch\u00f6berl","sequence":"additional","affiliation":[{"name":"Department of Neurology with Friedrich Baur Institute, LMU University Hospital, LMU Munich, Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katharina J","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"Department of Neurology with Friedrich Baur Institute, LMU University Hospital, LMU Munich, Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9553-9911","authenticated-orcid":false,"given":"Moritz L","family":"Schmidbauer","sequence":"additional","affiliation":[{"name":"Department of Neurology with Friedrich Baur Institute, LMU University Hospital, LMU Munich, Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Forbrig","sequence":"additional","affiliation":[{"name":"Institute of Neuroradiology, LMU University Hospital, LMU Munich, Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sigrun","family":"Roeber","sequence":"additional","affiliation":[{"name":"Center for Neuropathology and Prion Research, Faculty of Medicine, LMU Munich, Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jochen","family":"Herms","sequence":"additional","affiliation":[{"name":"Center for Neuropathology and Prion Research, Faculty of Medicine, LMU Munich, Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Terpolilli","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, LMU University Hospital, LMU Munich, Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Milena","family":"Milakovic Obradovic","sequence":"additional","affiliation":[{"name":"Max Von Pettenkofer Institute and Gene Center, Virology, National Reference Center for Retroviruses, Ludwig Maximilian University, Munich, Germany; 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