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Laryngospasm as an uncommon presentation in a patient with anti-N-methyl-D-aspartate receptor encephalitis: A case
Lu Wang1, Hong-Jun Su1, Guan-Jie Song2
1Department of Neurology, Tianjin Baodi Hospital, Tianjin 301800, China.
Background:
Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a rare autoimmune disorder. The symptoms of anti-NMDAR encephalitis include behavioral problems, speech problems, psychosis, seizures, and memory deficits, among others. However, laryngospasm is rare. We present the case of a patient with anti-NMDAR antibodies and severe laryngospasms.
Case Summary:
The patient was a 15-year-old female with normal psychomotor development. She was initially admitted to our neurological intensive care unit with seizures. She received anti-epilepsy treatment, and the seizures disappeared. However, 2 wk later, she developed behavioral problems and speech impairment. Then, she developed severe laryngospasms, which were treated with intubation and a tracheotomy. Antibodies against the NMDAR were detected in the patient's cerebrospinal fluid. Therefore, she was diagnosed with anti-NMDAR encephalitis. In addition, she received intravenously administered immunoglobulins, and methylprednisolone was administered. The patient's symptoms gradually improved, and she was discharged from our hospital. Approximately 9 mo later, the patient could speak sentences, walk independently, and carry out activities of daily living independently. Through our case report, we highlighted laryngospasm as an uncommon presentation in patients with anti-NMDAR encephalitis.
Conclusion:
Laryngospasm may be an uncommon clinical manifestation of anti-NMDAR encephalitis.
Insights
Severe laryngospasms, a rare symptom, occurred in a 15-year-old diagnosed with anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis. This case highlights laryngospasm as an uncommon presentation of this autoimmune neurological disorder.
Area of Science:
- Neurology
- Immunology
- Autoimmune Diseases
Background:
- Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a rare autoimmune disorder.
- Commonly presents with behavioral, speech, psychosis, seizure, and memory issues.
- Laryngospasm is an infrequent manifestation.
Observation:
- A 15-year-old female with normal development presented with seizures, behavioral problems, and speech impairment.
- Developed severe laryngospasms requiring intubation and tracheotomy.
- NMDAR antibodies detected in cerebrospinal fluid confirmed the diagnosis.
Findings:
- The patient received immunotherapy (intravenous immunoglobulins and methylprednisolone).
- Symptoms gradually improved, with significant recovery over 9 months.
- Laryngospasm was identified as an uncommon clinical presentation.
Implications:
- Highlights laryngospasm as a potential, albeit rare, symptom of anti-NMDAR encephalitis.
- Suggests considering anti-NMDAR encephalitis in patients presenting with unexplained laryngospasm.
- Emphasizes the importance of early diagnosis and treatment for improved patient outcomes.
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