The diffuse involvement of anti-N-methyl-D-aspartate receptor encephalitis in brain: a case report
Abstract Background Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a severe and most common autoimmune encephalitis in patients under 40 years old. Anti-NMDAR encephalitis has various clinical and neuroimaging findings. Here we report a special case of an anti-NMDAR encephalitis who had...
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| Format: | Article |
| Language: | English |
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BMC
2019-09-01
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| Series: | BMC Neurology |
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| Online Access: | http://link.springer.com/article/10.1186/s12883-019-1456-6 |
| _version_ | 1818980875514150912 |
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| author | Yun Jiang Jianpeng Ma Tao Gong Hongjun Hao Haibo Chen |
| author_facet | Yun Jiang Jianpeng Ma Tao Gong Hongjun Hao Haibo Chen |
| author_sort | Yun Jiang |
| collection | DOAJ |
| description | Abstract Background Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a severe and most common autoimmune encephalitis in patients under 40 years old. Anti-NMDAR encephalitis has various clinical and neuroimaging findings. Here we report a special case of an anti-NMDAR encephalitis who had diffuse lesions in bilateral hemispheres with mild mass effects in left basal ganglia area. Case presentations A 28-year-old female anti-NMDAR encephalitis patient mainly presented with headache and fever. Brain magnetic resonance image (MRI) showed slightly contrasted diffuse lesions, involving the left temporal and frontal lobes, left basal ganglia area and splenium of corpus callosum, as well as the right frontal lobe, with mild edema surrounded in the left basal ganglia area. Cerebrospinal fluid (CSF) revealed a moderate pleocytosis with normal protein and glucose levels. Anti-NMDAR antibodies were identified in CSF. Transvaginal ovarian ultrasound did not reveal an ovarian teratoma. The patient was treated with immunoglobulin and steroid, and had a good recovery. Conclusions Anti-NMDAR encephalitis has no special clinical manifestations and brain MRI is highly variable, which could be unremarkable or abnormal involving white and grey matters. The extensive lesions in frontal and temporal lobes, and basal ganglia area, with mild mass effects, have not been described previously. Recognition of various changes in brain MRI will enable the early detection of anti-NMDAR antibody and then effective treatments. |
| first_indexed | 2024-12-20T17:22:22Z |
| format | Article |
| id | doaj.art-1af6c644462c46c6b1bff124e4c3b623 |
| institution | Directory Open Access Journal |
| issn | 1471-2377 |
| language | English |
| last_indexed | 2024-12-20T17:22:22Z |
| publishDate | 2019-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Neurology |
| spelling | doaj.art-1af6c644462c46c6b1bff124e4c3b6232022-12-21T19:31:44ZengBMCBMC Neurology1471-23772019-09-011911610.1186/s12883-019-1456-6The diffuse involvement of anti-N-methyl-D-aspartate receptor encephalitis in brain: a case reportYun Jiang0Jianpeng Ma1Tao Gong2Hongjun Hao3Haibo Chen4Department of Neurology, Beijing Hospital, National Center of GerontologyDepartment of Neurology, Beijing Hospital, National Center of GerontologyDepartment of Neurology, Beijing Hospital, National Center of GerontologyDepartment of Neurology, Peking University First HospitalDepartment of Neurology, Beijing Hospital, National Center of GerontologyAbstract Background Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a severe and most common autoimmune encephalitis in patients under 40 years old. Anti-NMDAR encephalitis has various clinical and neuroimaging findings. Here we report a special case of an anti-NMDAR encephalitis who had diffuse lesions in bilateral hemispheres with mild mass effects in left basal ganglia area. Case presentations A 28-year-old female anti-NMDAR encephalitis patient mainly presented with headache and fever. Brain magnetic resonance image (MRI) showed slightly contrasted diffuse lesions, involving the left temporal and frontal lobes, left basal ganglia area and splenium of corpus callosum, as well as the right frontal lobe, with mild edema surrounded in the left basal ganglia area. Cerebrospinal fluid (CSF) revealed a moderate pleocytosis with normal protein and glucose levels. Anti-NMDAR antibodies were identified in CSF. Transvaginal ovarian ultrasound did not reveal an ovarian teratoma. The patient was treated with immunoglobulin and steroid, and had a good recovery. Conclusions Anti-NMDAR encephalitis has no special clinical manifestations and brain MRI is highly variable, which could be unremarkable or abnormal involving white and grey matters. The extensive lesions in frontal and temporal lobes, and basal ganglia area, with mild mass effects, have not been described previously. Recognition of various changes in brain MRI will enable the early detection of anti-NMDAR antibody and then effective treatments.http://link.springer.com/article/10.1186/s12883-019-1456-6Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitisClinicBrainMagnetic resonance image |
| spellingShingle | Yun Jiang Jianpeng Ma Tao Gong Hongjun Hao Haibo Chen The diffuse involvement of anti-N-methyl-D-aspartate receptor encephalitis in brain: a case report BMC Neurology Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis Clinic Brain Magnetic resonance image |
| title | The diffuse involvement of anti-N-methyl-D-aspartate receptor encephalitis in brain: a case report |
| title_full | The diffuse involvement of anti-N-methyl-D-aspartate receptor encephalitis in brain: a case report |
| title_fullStr | The diffuse involvement of anti-N-methyl-D-aspartate receptor encephalitis in brain: a case report |
| title_full_unstemmed | The diffuse involvement of anti-N-methyl-D-aspartate receptor encephalitis in brain: a case report |
| title_short | The diffuse involvement of anti-N-methyl-D-aspartate receptor encephalitis in brain: a case report |
| title_sort | diffuse involvement of anti n methyl d aspartate receptor encephalitis in brain a case report |
| topic | Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis Clinic Brain Magnetic resonance image |
| url | http://link.springer.com/article/10.1186/s12883-019-1456-6 |
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