Background Anti-N-methyl-D-aspartate receptor(anti-NMDAR)encephalitis is a novel autoimmune encephalitis(AE)first identified in 2007.It provides a new direction for clinicians when encountering unexplained symptoms su...Background Anti-N-methyl-D-aspartate receptor(anti-NMDAR)encephalitis is a novel autoimmune encephalitis(AE)first identified in 2007.It provides a new direction for clinicians when encountering unexplained symptoms such as seizures,psychotic behavioral abnormalities,speech disorders,and involuntary movements.Most patients have a good prognosis after immunotherapy,but some may experience relapses.Case presentation We report a Chinese female patient diagnosed with anti-NMDAR encephalitis.Over the past 30 years,the patient had experienced eight episodes with seizures as the first symptom,which eventually progressed to autoimmune-associated epilepsy.In the last two episodes,both serum and cerebrospinal fluid of the patient were negative for AE-related antibodies,and brain magnetic resonance imaging(MRI)revealed abnormal hyperintensity in the bilateral hippocampi.The patient’s symptoms were poorly controlled by immunotherapy but well controlled by anti-seizure medicines.Conclusions Patients with a long history of AE and multiple relapses that start with seizures may display alterations of brain structure.Physicians should pay attention to autoimmune-associated epilepsy.展开更多
基金This work was supported by the Joint Medical Research Project of Chongqing Science&Technology and Health Commission(2020FYYX081)High-Level Medical Reserved Personnel Training Project of Chongqing,and Natural Science Foundation of Yuzhong Direct,Chongqing(20190129).
文摘Background Anti-N-methyl-D-aspartate receptor(anti-NMDAR)encephalitis is a novel autoimmune encephalitis(AE)first identified in 2007.It provides a new direction for clinicians when encountering unexplained symptoms such as seizures,psychotic behavioral abnormalities,speech disorders,and involuntary movements.Most patients have a good prognosis after immunotherapy,but some may experience relapses.Case presentation We report a Chinese female patient diagnosed with anti-NMDAR encephalitis.Over the past 30 years,the patient had experienced eight episodes with seizures as the first symptom,which eventually progressed to autoimmune-associated epilepsy.In the last two episodes,both serum and cerebrospinal fluid of the patient were negative for AE-related antibodies,and brain magnetic resonance imaging(MRI)revealed abnormal hyperintensity in the bilateral hippocampi.The patient’s symptoms were poorly controlled by immunotherapy but well controlled by anti-seizure medicines.Conclusions Patients with a long history of AE and multiple relapses that start with seizures may display alterations of brain structure.Physicians should pay attention to autoimmune-associated epilepsy.
