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2015 ; 15
(ä): 107
Nephropedia Template TP
gab.com Text
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Twit Text #
English Wikipedia
Anti-N-methyl-D-aspartate receptor encephalitis concomitant with multifocal
subcortical white matter lesions on magnetic resonance imaging: a case report and
review of the literature
#MMPMID26152327
Wang RJ
; Chen BD
; Qi D
BMC Neurol
2015[Jul]; 15
(ä): 107
PMID26152327
show ga
BACKGROUND: Anti-N-methyl-D-aspartate receptor encephalitis is a severe
autoimmune disorder characterized by severe psychiatric symptoms, seizures,
decreased consciousness, autonomic dysregulation, and dyskinesias. Multifocal
subcortical white matter lesions on fluid-attenuated inversion recovery and
diffuse weighted images have rarely been reported in previous literature, and
serial magnetic resonance imaging changes after plasma exchange have not been
presented before. CASE PRESENTATION: A previously healthy 24-year-old Chinese
woman presented with acute psychiatric symptoms characterized by fear and
agitation followed by decreased consciousness, dyskinesias, and seizures.
Magnetic resonance imaging revealed hyperintense lesions on fluid-attenuated
inversion recovery and diffuse weighted images in bilateral subcortical white
matter. Cerebrospinal fluid analysis revealed a mild pleocytosis with lymphocytic
predominance. Protein and glucose levels were normal. Aquaporin-4 antibodies in
serum and cerebrospinal fluid were negative. Identification of
anti-N-methyl-D-aspartate receptor antibodies in serum and cerebrospinal fluid
confirmed the diagnosis of anti-N-methyl-D-aspartate receptor encephalitis. She
was initially treated with combined intravenous immunoglobulin and
methylprednisolone without improvement. Plasma exchange was then initiated with
good response; the patient made a full recovery after several cycles of plasma
exchange. Repeat magnetic resonance imaging performed 1 month after plasma
exchange showed partial resolution of the hyperintense lesions in bilateral
subcortical white matter, and follow-up magnetic resonance imaging 2 months after
plasma exchange showed complete resolution. CONCLUSION: Anti-N-methyl-D-aspartate
receptor encephalitis may be concomitant with multifocal subcortical white matter
lesions. Such lesions may resolve after appropriate immunotherapy.