Case report: Isolated brainstem-cerebellar symptoms in a patient with anti-NMDA receptor encephalitis

Front Immunol. 2024 May 10:15:1388667. doi: 10.3389/fimmu.2024.1388667. eCollection 2024.

Abstract

Cerebellar ataxia is an uncommon and atypical manifestation of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis, often accompanied by seizures, psychiatric symptoms, and cognitive deficits. Previous cases of isolated brainstem-cerebellar symptoms in patients with anti-NMDAR encephalitis have not been documented. This report presents a case of anti-NMDAR encephalitis in which the patient exhibited cerebellar ataxia, nystagmus, diplopia, positive bilateral pathological signs, and hemiparesthesia with no other accompanying symptoms or signs. The presence of positive CSF anti-NMDAR antibodies further supports the diagnosis. Other autoantibodies were excluded through the use of cell-based assays. Immunotherapy was subsequently administered, leading to a gradual recovery of the patient.

Keywords: Isolated brainstem-cerebellar symptoms; anti-NMDAR encephalitis; ataxia; brainstem symptoms; encephalitis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-N-Methyl-D-Aspartate Receptor Encephalitis* / diagnosis
  • Autoantibodies* / blood
  • Autoantibodies* / cerebrospinal fluid
  • Autoantibodies* / immunology
  • Brain Stem* / pathology
  • Cerebellar Ataxia / diagnosis
  • Cerebellar Ataxia / etiology
  • Cerebellar Ataxia / immunology
  • Cerebellum / diagnostic imaging
  • Cerebellum / pathology
  • Female
  • Humans
  • Immunotherapy
  • Magnetic Resonance Imaging
  • Male
  • Receptors, N-Methyl-D-Aspartate / immunology

Substances

  • Autoantibodies
  • Receptors, N-Methyl-D-Aspartate

Grants and funding

The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.