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Related Concept Videos

Encephalitis l: Introduction01:19

Encephalitis l: Introduction

Encephalitis is inflammation of the brain parenchyma, most often due to infections or autoimmune processes. It presents with neuropsychiatric features such as fever, altered mental status, behavioral changes, cognitive dysfunction, seizures, focal deficits, and sometimes autonomic instability. In some cases, the meninges are also involved, resulting in meningoencephalitis.Infectious CausesInfectious encephalitis is most commonly viral but can also result from bacterial, fungal, or parasitic...
Encephalitis ll: Pathophysiology01:26

Encephalitis ll: Pathophysiology

Encephalitis is inflammation of the brain parenchyma caused by direct viral invasion or immune-mediated mechanisms triggered by infections or tumors. Both processes lead to neuronal injury, disrupted neurotransmission, and diverse neurological symptoms, often with overlapping clinical and pathological features.Autoimmune EncephalitisIn autoimmune encephalitis, antibodies target neuronal antigens on cell surfaces, synapses, or within neurons. A key example is anti-NMDAR encephalitis, which can...
Arboviral Encephalitis01:25

Arboviral Encephalitis

Arboviral encephalitis refers to brain inflammation caused by arthropod-borne viruses, particularly those transmitted through mosquito vectors. Among these, West Nile virus (WNV), a member of the Flaviviridae family, is a significant public health concern. WNV is an enveloped, positive-sense, single-stranded RNA virus. Human infection typically begins when an infected mosquito introduces the virus into the dermis during feeding. The primary transmission cycle involves birds as amplifying hosts...

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A Simple Cell-based Immunofluorescence Assay to Detect Autoantibody Against the N-Methyl-D-Aspartate (NMDA) Receptor in Blood
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[Anti-NMDA receptor encephalitis during pregnancy].

Yasuo Ito1, Tatsuya Abe, Ryo Tomioka

  • 1Department of Neurology, Faculty of Medicine, Saitama Medical University.

Rinsho Shinkeigaku = Clinical Neurology
|March 4, 2010
PubMed
Summary

This case study describes a pregnant woman diagnosed with anti-N-methyl-D-aspartate (NMDA) receptor encephalitis. The condition improved after treatment, leading to a healthy delivery and recovery.

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Published on: June 2, 2022

Area of Science:

  • Neuroimmunology
  • Obstetrics
  • Neurology

Background:

  • Autoimmune encephalitis during pregnancy presents diagnostic challenges, often mimicking psychiatric disorders.
  • Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is a severe autoimmune neurological disorder.
  • Pregnancy can trigger or exacerbate autoimmune conditions due to complex immunological interactions.

Observation:

  • A 19-year-old pregnant female presented with rapid behavioral changes, altered consciousness, and neurological deficits.
  • Initial diagnosis was schizophrenia, later revised to suspected encephalitis due to EEG findings and clinical signs like hyperhidrosis and oral dyskinesia.
  • Cerebrospinal fluid analysis was negative for HSV, and brain imaging revealed no abnormalities, complicating the diagnosis.

Findings:

  • The patient was diagnosed with anti-NMDA receptor (anti-NMDAR) encephalitis confirmed by the presence of anti-NMDAR antibodies in CSF.
  • Treatment with methylprednisolone and phenobarbital was initiated, with antibody titers decreasing during treatment and post-delivery.
  • The patient experienced a normal delivery at 37 weeks, with both mother and baby remaining healthy without sequelae.

Implications:

  • This case highlights the importance of considering autoimmune encephalitis in pregnant patients with unexplained neurological and psychiatric symptoms.
  • The findings suggest that pregnancy may trigger anti-NMDAR encephalitis through immunological modulation by the embryo or placenta.
  • Early diagnosis and treatment of anti-NMDAR encephalitis in pregnancy are crucial for favorable maternal and fetal outcomes.