Anti-N-methyl-d-aspartate receptor encephalitis in a patient with neuromyelitis optica spectrum disorders

Mult Scler Relat Disord. 2016 Jul:8:74-7. doi: 10.1016/j.msard.2016.05.002. Epub 2016 May 2.

Abstract

We described a female patient with anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis occurring sequentially with neuromyelitis optica spectrum disorders (NMOSD). The 19-year-old patient initially presented a diencephalic syndrome with aquaporin-4 immunoglobulin G antibodies (AQP4-IgG) and brain lesions which involving bilateral medial temporal lobes and periependymal surfaces of the third ventricle on magnetic resonance imaging (MRI). Ten months later, the patient developed cognitive impairment, psychiatric symptoms and dyskinesia with left basal ganglia lesions on brain MRI. Meanwhile, the anti-NMDAR antibodies were positive in the patient's serum and cerebrospinal fluid, while the screening tests for an ovarian teratoma and other tumors were all negative. Hence, the patient was diagnosed NMOSD and anti-NMDAR encephalitis followed by low-dose rituximab treatment with a good response. This case was another evidence for demyelinating syndromes overlapping anti-NMDAR encephalitis in Chinese patients.

Keywords: Anti-N-methyl-d-aspartate receptor encephalitis; Aquaporin-4; Demyelination; N-methyl-d-aspartate receptor; Neuromyelitis optica spectrum disorders.

Publication types

  • Case Reports

MeSH terms

  • Anti-N-Methyl-D-Aspartate Receptor Encephalitis / complications*
  • Anti-N-Methyl-D-Aspartate Receptor Encephalitis / diagnostic imaging
  • Anti-N-Methyl-D-Aspartate Receptor Encephalitis / drug therapy
  • Brain / diagnostic imaging
  • Female
  • Humans
  • Immunologic Factors / therapeutic use
  • Neuromyelitis Optica / complications*
  • Neuromyelitis Optica / diagnostic imaging
  • Neuromyelitis Optica / drug therapy
  • Rituximab / therapeutic use
  • Young Adult

Substances

  • Immunologic Factors
  • Rituximab