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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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Solitary juxtacortical lesion associated with anti-N-methyl-D-aspartate receptor encephalitis: a case report

Rupan Gao1, Xiang Zhang2, Abhijeet Kumar Bhekharee3

  • 1Department of Hematology, Zhongshan Hospital, Fudan University, Shanghai, China.

BMC Neurology
|November 21, 2020
PubMed
Abstract

Insights

Anti-NMDA receptor encephalitis, a severe autoimmune condition, can rarely present with a single brain lesion. Prompt diagnosis via antibody testing is crucial for effective treatment and recovery.

Area of Science:

  • Neurology
  • Immunology
  • Radiology

Background:

  • Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is a severe autoimmune disorder.
  • It is characterized by antibodies targeting NMDA receptors in the brain.
  • Typical brain MRI findings are non-specific and often diffuse or multifocal.

Observation:

  • A 16-year-old female presented with focal seizures, progressing to psychiatric and extrapyramidal symptoms.
  • Brain MRI revealed a unique solitary juxtacortical demyelinating lesion in the left frontal lobe without enhancement.
  • EEG showed epileptiform discharges localized to the lesion area.

Findings:

  • Serum and cerebrospinal fluid tested positive for NMDAR IgGs.
  • The patient received corticosteroid and intravenous immunoglobulin therapy.
  • Complete recovery was observed, with MRI showing a fainter lesion post-treatment.

Implications:

  • This case highlights that anti-NMDA receptor encephalitis can manifest with a solitary brain lesion, a rare presentation.
  • Comprehensive antibody testing for autoimmune encephalitis is critical for accurate diagnosis.
  • Early diagnosis and treatment lead to favorable outcomes in anti-NMDA receptor encephalitis.
Keywords:
Anti-N-methyl-D-aspartate receptor encephalitisDemyelinationElectroencephalogramJuxtacortical lesionSeizure

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