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Isolated Leptomeningeal Enhancement in Anti-N-Methyl D-Aspartate Receptor Encephalitis: The Diagnostic Value of
Abstract:
Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a common autoimmune encephalitis that is noted to be a severe but treatable disease entity. Patients with anti-NMDAR encephalitis often develop psychotic symptoms, including delusions, hallucinations, and paranoia, as well as memory impairment and persistent loss of attention. However, MRI findings in such patients show no abnormalities in most cases. Although typical brain abnormality features, known as T2 hyperintensities, involve the brain parenchyma and contrast enhancement at the cerebral cortex or overlying meninges, isolated leptomeningeal enhancement has been rarely reported in anti-NMDAR encephalitis. Herein, we report a patient with anti-NMDAR encephalitis who presented with isolated leptomeningeal enhancement, additionally showing the diagnostic value of contrast-enhanced fluid-attenuated inversion recovery imaging.
Insights
Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis can cause severe neurological and psychiatric symptoms. This case highlights isolated leptomeningeal enhancement on MRI, a rare finding, and the utility of contrast-enhanced FLAIR imaging in diagnosis.
Area of Science:
- Neurology
- Immunology
- Radiology
Background:
- Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a severe autoimmune disorder.
- Patients often present with psychiatric and cognitive symptoms.
- Standard MRI findings are frequently normal, complicating diagnosis.
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