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First Bahraini adolescent with anti-NMDAR-Ab encephalitis

Anti-N-methyl-D-aspartate-receptor (NMDA-R) encephalitis is a new autoimmune, often paraneoplastic disorder that presents with complex neuropsychiatric symptoms. It was first described in 2007 by Dalmau et al. Our patient presented with headache, behavioral changes and then seizures with hallucinati...

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Detalles Bibliográficos
Autores principales: Almuslamani, Ahood, Mahmood, Fatima
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Bloomsbury Qatar Foundation Journals 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4614336/
https://www.ncbi.nlm.nih.gov/pubmed/26535170
http://dx.doi.org/10.5339/qmj.2015.2
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author Almuslamani, Ahood
Mahmood, Fatima
author_facet Almuslamani, Ahood
Mahmood, Fatima
author_sort Almuslamani, Ahood
collection PubMed
description Anti-N-methyl-D-aspartate-receptor (NMDA-R) encephalitis is a new autoimmune, often paraneoplastic disorder that presents with complex neuropsychiatric symptoms. It was first described in 2007 by Dalmau et al. Our patient presented with headache, behavioral changes and then seizures with hallucinations. She was initially misdiagnosed to have schizophrenia and was prescribed antipsychotics. She deteriorated and developed further seizures with hypoventilation and choreoathetosis. Her blood investigations were positive for mycoplasma IGM. Her CSF studies showed high white cell counts, predominantly lymphocytes, and high anti-NMDA-R titre. Her brain MRI scans showed high tbl2 and FLAIR intensities in the grey and white matter of the left cerebellar hemisphere suggestive of acute disseminated encephalomyelitis. She responded to treatment with antibiotics, multiple antiepileptics, steroids and needed five sessions of plasmapheresis. There was no underlying malignancy on repeated scanning of the abdomen. She needed around one year for full recovery with intensive rehabilitation. The objective of this paper was to highlight the occurrence of this fairly new, challenging, easily missed, not-so-rare form of encephalitis often occurring in the absence of fever.
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spelling pubmed-46143362015-11-03 First Bahraini adolescent with anti-NMDAR-Ab encephalitis Almuslamani, Ahood Mahmood, Fatima Qatar Med J Case Report Anti-N-methyl-D-aspartate-receptor (NMDA-R) encephalitis is a new autoimmune, often paraneoplastic disorder that presents with complex neuropsychiatric symptoms. It was first described in 2007 by Dalmau et al. Our patient presented with headache, behavioral changes and then seizures with hallucinations. She was initially misdiagnosed to have schizophrenia and was prescribed antipsychotics. She deteriorated and developed further seizures with hypoventilation and choreoathetosis. Her blood investigations were positive for mycoplasma IGM. Her CSF studies showed high white cell counts, predominantly lymphocytes, and high anti-NMDA-R titre. Her brain MRI scans showed high tbl2 and FLAIR intensities in the grey and white matter of the left cerebellar hemisphere suggestive of acute disseminated encephalomyelitis. She responded to treatment with antibiotics, multiple antiepileptics, steroids and needed five sessions of plasmapheresis. There was no underlying malignancy on repeated scanning of the abdomen. She needed around one year for full recovery with intensive rehabilitation. The objective of this paper was to highlight the occurrence of this fairly new, challenging, easily missed, not-so-rare form of encephalitis often occurring in the absence of fever. Bloomsbury Qatar Foundation Journals 2015-05-14 /pmc/articles/PMC4614336/ /pubmed/26535170 http://dx.doi.org/10.5339/qmj.2015.2 Text en © 2015 Almuslamani, Mahmood, licensee Bloomsbury Qatar Foundation Journals. This is an open access article distributed under the terms of the Creative Commons Attribution license CC BY 4.0, which permits unrestricted use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Almuslamani, Ahood
Mahmood, Fatima
First Bahraini adolescent with anti-NMDAR-Ab encephalitis
title First Bahraini adolescent with anti-NMDAR-Ab encephalitis
title_full First Bahraini adolescent with anti-NMDAR-Ab encephalitis
title_fullStr First Bahraini adolescent with anti-NMDAR-Ab encephalitis
title_full_unstemmed First Bahraini adolescent with anti-NMDAR-Ab encephalitis
title_short First Bahraini adolescent with anti-NMDAR-Ab encephalitis
title_sort first bahraini adolescent with anti-nmdar-ab encephalitis
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4614336/
https://www.ncbi.nlm.nih.gov/pubmed/26535170
http://dx.doi.org/10.5339/qmj.2015.2
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