[Subacute encephalitis associated with anti-glutamate receptor antibodies: serial studies of MRI, 1H-MRS and SPECT]

Rinsho Shinkeigaku. 2008 Mar;48(3):196-201. doi: 10.5692/clinicalneurol.48.196.
[Article in Japanese]

Abstract

A 32-year-old man who had experienced fever and a pulsating headache of the right occipital region for a month and a transient left hemianopia and numbness in the left arm two weeks prior to presentation was admitted to our hospital because of a seizure. Fluid-attenuated inversion recovery and diffusion-weighted magnetic resonance imaging (MRI) showed high-intensity signals, without reduction of apparent diffusion coefficient value, in the right temporo-occipital cortices. Proton MR spectroscopy (1H-MRS) indicated a decrease in N-acetylaspartate, and single-photon emission CT (SPECT) showed hyperperfusion in the right temporo-occipital territory. An examination of the cerebrospinal fluid showed an elevation of mononuclear cells and the presence of anti-glutamate epsilon2 receptor antibodies. All abnormalities shown by these imaging techniques were normalized in the clinical course. This report suggests that MRI, 1H-MRS and SPECT studies were useful in understanding the pathogenesis of encephalitis associated with glutamate receptor antibodies.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Adult
  • Autoantibodies*
  • Encephalitis / diagnosis*
  • Encephalitis / drug therapy
  • Encephalitis / immunology*
  • Humans
  • Image Enhancement
  • Magnetic Resonance Imaging*
  • Magnetic Resonance Spectroscopy*
  • Male
  • Methylprednisolone / administration & dosage
  • Pulse Therapy, Drug
  • Receptors, N-Methyl-D-Aspartate / immunology*
  • Tomography, Emission-Computed, Single-Photon*
  • Treatment Outcome

Substances

  • Autoantibodies
  • NR2B NMDA receptor
  • Receptors, N-Methyl-D-Aspartate
  • Methylprednisolone