Published in:
Open Access
01-12-2013 | Case report
Extensive myelitis associated with anti-NMDA receptor antibodies
Authors:
Olivier Outteryck, Guillaume Baille, Jérôme Hodel, Marianne Giroux, Arnaud Lacour, Jérôme Honnorat, Hélène Zéphir, Patrick Vermersch
Published in:
BMC Neurology
|
Issue 1/2013
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Abstract
Background
Encephalitis with anti-N-methyl-D-aspartate receptor antibodies (anti-NMDAR-Ab) is a rapid-onset encephalitis including psychosis, seizures, various movement disorders and autonomic system disturbances.
Case presentation
We report a very unusual case of extensive myelitis associated with anti-NMDAR-Ab. MRI also revealed a hyperintense T2 lesion, non-suggestive of MS, which progressively extended, associated with periventricular gadolinium enhancement visualized on brain MRI. Ophthalmological evaluation showed subclinical right optic neuritis. The absence of anti-AQP4 antibody argued against neuromyelitis optica spectrum disorder. A slight psychomotor slowing prompted us to search for various causes of autoimmune encephalitis. Anti-NMDAR-Ab was found in cerebrospinal fluid.
Conclusion
In patients with extensive myelitis who are seronegative for anti-AQP4 antibodies, and after other classical causes have been excluded, the hypothesis of atypical anti-NMDAR-Ab encephalitis should also be considered.