Acupuncture for Symptomatic Management in Suspected CSF1R-Related Leukoencephalopathy: A Case Report

Objective: To describe symptomatic and functional changes observed during acupuncture treatment in a patient with suspected CSF1R-related leukoencephalopathy. Case: A 43-year-old woman with progressive neurological impairment began weekly acupuncture at our institution on November 8, 2024. The report focuses on an initial 8-month treatment period. Direct clinical observation by the second author began in January 2025. Concurrent treatment included weekly physiotherapy and chiropractic treatment; no disease-specific long-term pharmacologic treatment was reported by the patient’s husband. Results: During the early treatment period, the patient exhibited marked lower-limb stiffness and heightened physical reactivity to touch and needling. Even light stimulation could elicit pronounced stiffening of the lower limbs, and needle insertion was difficult because of marked tissue resistance. As treatment continued, these reactions became less pronounced: the limbs appeared more relaxed, passive movement and needle insertion became easier, and excessive responses to touch were less frequently observed. During subsequent periods of regular acupuncture, this relatively improved state was generally maintained, with less bodily stiffness, easier needling, a more upright sitting posture, and calmer, more responsive behavior. When acupuncture was interrupted, these features tended to become less apparent, while greater stiffness and heightened physical reactivity tended to recur. These observations were clinical and temporal in nature and were not based on standardized quantitative outcome measures. Conclusion: During the initial 8-month treatment period, repeated symptomatic and functional improvements were observed during periods of regular acupuncture. Recurrence of greater stiffness and reactivity after treatment interruptions further suggested a temporal relationship between regular acupuncture and symptom control. Although long-term follow-up showed continued progression of the underlying neurological disease, these observations suggest a potential adjunctive role for acupuncture in symptomatic and functional management of progressive leukoencephalopathy and warrant further investigation using standardized outcome measures.