Related Experiment Video
Updated: Dec 27, 2025
High-throughput Flow Cytometry Cell-based Assay to Detect Antibodies to N-Methyl-D-aspartate Receptor or Dopamine-2 Receptor in Human Serum
Published on: November 23, 2013
Extreme delta brush patterns guide the complex motor phenomenon of anti-NMDA receptor encephalitis: A case report
Yu-Ming Chen1,2, Pei-Hsin Kuo1,2
1Department of Neurology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation.
Rationale:
Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is an autoimmune disease that is associated with cell-surface NMDAR-targeting autoantibodies. Typical anti-NMDAR encephalitis symptoms include psychosis, seizure and extrapyramidal side effects. However, early diagnosis of anti-NMDAR encephalitis remains challenging due to the complexity of the motor phenomenon.
Patient Concerns:
Here, we report a new diagnosis of anti-NMDAR encephalitis in a young woman with a history of epilepsy.
Diagnoses:
Electroencephalography revealed a typical "extreme delta brush" pattern, which indicated anti-NMDAR encephalitis.
Interventions:
The clinical status of the patient markedly improved after immediate and aggressive immunosuppression therapies.
Outcomes:
The patient was discharged with mild cognitive impairment. However, this was completely resolved 1 month postdischarge.
Lessons:
We conclude that subacute onset focal seizure with psychosis as well as compatible electroencephalography findings (i.e., extreme delta brush patterns) should be considered notable early indicators of anti-NMDAR encephalitis. This would ensure early and effective clinical interventions, which are essential for favorable outcomes.
Insights
Early diagnosis of anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is crucial. Subacute focal seizures with psychosis and extreme delta brush patterns on EEG are key early indicators for prompt treatment and better outcomes.
Area of Science:
- Neurology
- Immunology
- Autoimmune Diseases
Background:
- Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is an autoimmune disorder characterized by NMDAR-targeting autoantibodies.
- Clinical presentation often includes psychosis, seizures, and extrapyramidal symptoms, complicating early diagnosis.
Observation:
- A case study of a young woman with a history of epilepsy presenting with anti-NMDAR encephalitis.
- Electroencephalography (EEG) demonstrated the characteristic "extreme delta brush" pattern, a key diagnostic marker.
Findings:
- The patient experienced subacute onset focal seizures with psychosis.
- The "extreme delta brush" EEG pattern strongly indicated anti-NMDAR encephalitis.
- Rapid and aggressive immunosuppression therapy led to significant clinical improvement.
Implications:
- Subacute focal seizures with psychosis and "extreme delta brush" EEG patterns are vital early indicators of anti-NMDAR encephalitis.
- Early identification facilitates timely and effective immunosuppressive interventions.
- Prompt treatment is essential for achieving favorable patient outcomes and resolving cognitive impairment.
More Related Videos
07:20A Simple Cell-based Immunofluorescence Assay to Detect Autoantibody Against the N-Methyl-D-Aspartate NMDA Receptor in Blood
Published on: January 9, 2018
08:20Hippocampal Neuronal Cultures to Detect and Study New Pathogenic Antibodies Involved in Autoimmune Encephalitis
Published on: June 2, 2022