NMDAR encephalitis presenting as akinesia in a patient with Parkinson disease

Matteo Gastaldi; Carla Arbasino; Carlo Dallocchio; Luca Diamanti; Paola Bini; Enrico Marchioni; Diego Franciotta

doi:10.1016/j.jneuroim.2018.12.002

NMDAR encephalitis presenting as akinesia in a patient with Parkinson disease

J Neuroimmunol. 2019 Mar 15:328:35-37. doi: 10.1016/j.jneuroim.2018.12.002. Epub 2018 Dec 12.

Authors

Matteo Gastaldi¹, Carla Arbasino², Carlo Dallocchio², Luca Diamanti³, Paola Bini³, Enrico Marchioni³, Diego Franciotta⁴

Affiliations

¹ Neuroimmunology Laboratory, IRCCS Mondino Foundation, Pavia, Italy.
² Neurology Unit, ASST Pavia-Ospedale Civile di Voghera, Voghera, Italy.
³ Neuroncology and Neuroinflammation Unit, IRCCS Mondino Foundation, Pavia, Italy.
⁴ Neuroimmunology Laboratory, IRCCS Mondino Foundation, Pavia, Italy. Electronic address: [email protected].

PMID: 30557688
DOI: 10.1016/j.jneuroim.2018.12.002

Abstract

We describe the case of a woman with Parkinson disease who developed an N-methyl-d-aspartate receptor antibody-mediated encephalitis. As a novelty, the encephalitis presentation mimicked a worsening of the pre-existing extrapyramidal syndrome, manifesting mainly as severe bradykinesia and, eventually, akinesia. Brain MRI was normal, whereas cerebrospinal fluid (CSF) analysis disclosed unique-to-CSF oligoclonal bands. Prompt identification and timely immunotherapy led to a complete recovery.

Keywords: Akinesia; Autoantibodies; Autoimmune encephalitis; NMDAR encephalitis; Parkinson disease.

Publication types

Case Reports
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Anti-N-Methyl-D-Aspartate Receptor Encephalitis / complications*
Anti-N-Methyl-D-Aspartate Receptor Encephalitis / drug therapy
Female
Humans
Immunoglobulins, Intravenous / therapeutic use
Parkinson Disease / complications*

Substances

Immunoglobulins, Intravenous