Primary lateral sclerosis-like picture in a patient with a remote history of anti-N-methyl-D- aspartate receptor (anti-NMDAR) antibody encephalitis

BMJ Case Rep. 2018 Jun 10:2018:bcr2017224060. doi: 10.1136/bcr-2017-224060.

Abstract

Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a well-recognised disorder, first fully characterised in 2007. The long-term sequelae reported thus far include relapses with typical, as well as partial aspects of the well-defined neuropsychiatric syndrome. Rarely, isolated atypical symptoms (diplopia, ataxia and tremor) have been reported as relapse phenomenon. We report a case of a patient with a remote history of likely anti-NMDAR encephalitis with the longest follow-up reported in the literature to date (22 years). The relapse presentation was of a purely upper motor neuron syndrome with a primary lateral sclerosis-like picture.

Keywords: immunology; motor neurone disease; neurology.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-N-Methyl-D-Aspartate Receptor Encephalitis / complications*
  • Autoantibodies / cerebrospinal fluid
  • Brain / diagnostic imaging
  • Female
  • Gait Disorders, Neurologic / etiology
  • Humans
  • Magnetic Resonance Imaging
  • Motor Neuron Disease / complications*
  • Muscle Spasticity / etiology
  • Positron Emission Tomography Computed Tomography
  • Receptors, N-Methyl-D-Aspartate / immunology*
  • Recurrence

Substances

  • Autoantibodies
  • Receptors, N-Methyl-D-Aspartate