NMDA Encephalitis: Case report and literature review
NMDA Encephalitis: Case report and literature review
DOI:
https://doi.org/10.59420/remus.5.2021.22Keywords:
Encephalitis, NMDAr, Autoimmune encephalitisAbstract
Autoimmune encephalitis characterized by the presence of IgG antibodies to the GluR1 subunit of Nmethyl-D-Aspartate receptor (NMDAr) mainly affects women over 18 years old and is commonly associated with an ovarian teratoma. It was previously described as a paraneoplastic disease; however, it has been shown that it affects both genders and that the condition may be present without an underlying tumor. We present a case of a 20-year-old female who initially presented headaches, followed by behavioral changes. After that, she progressed to a catatonic state and central hypoventilation, requiring admission to intensive care. During her hospital stay, she presented autonomic dysfunction and dyskinesias. A serum diagnosis of anti-NMDAr encephalitis is made, starting immunosuppressive treatment with steroids, followed by rituximab. The patient had a remarkable improvement and complete recovery from the disease.
Downloads
References
Guasp M, Dalmau J. Encefalitis por anticuerpos contra el receptor de NMDA. Med Clin (Barc) [Internet]. 2017;(xx):1–9. Available from: http://dx.doi.org/10.1016/j.medcli.2017.10.015
Lazar-molnar E, Tebo AE. Autoimmune NMDA receptor encephalitis. Clin Chim Acta [Internet]. 2015;438:90–7. Available from: http://dx.doi.org/10.1016/j.cca.2014.08.010
Dalmau J, Gleichman AJ, Hughes EG, Rossi JE, Peng X, Dessain SK, et al. Anti-NMDA-receptor encephalitis: case series and analysis of the effects of antibodies. Lancet Neurol. 2009;7(12):1091–8.
Cervantes-arriaga A, Calleja-castillo JM. Encefalitis por anticuerpos antirreceptor de N-metil -D-aspartato ( anti-NMDAR ): reporte de un caso. Gac Med Mex. 2014;150(0):2–5.
Graus F, Titulaer MJ, Balu R, Benseler S, Bien CG, Cellucci T, et al. Position Paper A clinical approach to diagnosis of autoimmune encephalitis. Lancet Neurol. 2016;4422(15):1–14.
Titulaer MJ, Mccracken L, Gabilondo I, Armangué T, Glaser C, Iizuka T, et al. Treatment and prognostic factors for long-term outcome in patients with antiNMDA receptor encephalitis : an observational cohort study. Lancet Neurol [Internet]. 2013;4422 (12):1–9. Available from: http://dx.doi.org/10.1016/S1474-4422(12)70310-1
Escudero Sanchez R, Montojo Villasanta M, Gonzalez Anglada M. Cartas cientıficas. Encefalitis asociada a anticuerpos contra el receptor NMDA. Med Clin Barc. 2015;145(11):504-5.6.
Lynch DR, Rattelle A, Dong YN, Roslin K, Gleichman AJ, Panzer JA. Anti-NMDA Receptor Encephalitis : Clinical Features and Basic Mechanisms [Internet]. 1st ed. Vol. 82, Advances in Pharmacology. Elsevier Inc.; 2018. 235–260 p. Available from: http://dx.doi.org/10.1016/bs.apha.2017.08.005
Jones KC, Benseler SM. A n t i – N M D A Re c e p t o r Encephalitis. Neuroimaging Clin NA [Internet]. 2005;23(2):309–20. Available from: http://dx.doi.org/10.1016/j.nic.2012.12.009
Freund B, Ritzl EK. Review article A review of EEG in antiNMDA receptor encephalitis. J Neuroimmunol [Internet]. 2019;332(March):64–8. Available from: https://doi.org/10.1016/j.jneuroim.2019.03.010
Wang H. Efficacies of treatments for anti-NMDA receptor encephalitis. 2016;651–63.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2020 REMUS - Revista Estudiantil de Medicina de la Universidad de Sonora
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
