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Reminder of important clinical lesson
CASE REPORT
Severe tooth loss secondary to orofacial dyskinesias in anti-NMDA receptor encephalitis
  1. Daniel Garbin Di Luca and
  2. Jason H Margolesky
  1. Department of Neurology, University of Miami School of Medicine, Miami, Florida, USA
  1. Correspondence to Dr Daniel Garbin Di Luca, daniel.garbindiluc{at}jhsmiami.org

Abstract

A 24-year-old woman with no significant medical or psychiatric history was brought to the emergency department due to altered mental status and bizarre behaviour. Physical examination was remarkable for decreased speech output and orofacial dyskinesia. Upon further evaluation, electroencephalogram showed extreme delta brush waves and cerebrospinal fluid was positive for anti-NMDA receptor antibodies. Despite aggressive treatment with steroids and immunosuppressive therapy, her dyskinesia was severe enough to cause tooth loss, tongue and lip laceration.

  • epilepsy and seizures
  • movement disorders (other than parkinsons)
  • neurology

https://doi.org/10.1136/bcr-2018-228380

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    Footnotes

    • Contributors DGDL, MD: video footage, review of the literature, patient consent and drafting the case report. JHM, MD: critical review of the manuscript and final approval of the version to be published.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Patient consent for publication Obtained.