Temporal Changes on (123)I-Iomazenil and Cerebral Blood Flow Single-photon Emission Computed Tomography in a Patient with Anti-N-methyl-D-aspartate Receptor Encephalitis

A 45-year-old man was admitted due to tonic seizures, aphasia, disturbance of consciousness, and abnormal behavior. Because cerebral magnetic resonance imaging findings were normal and mild cerebrospinal fluid (CSF) pleocytosis was observed, autoimmune encephalitis was suspected. The presence of ant...

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Autores principales: Kasahara, Hiroo, Sato, Masayuki, Nagamine, Shun, Makioka, Kouki, Tanaka, Keiko, Ikeda, Yoshio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society of Internal Medicine 2019
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6548939/
https://www.ncbi.nlm.nih.gov/pubmed/30713292
http://dx.doi.org/10.2169/internalmedicine.0987-18
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author Kasahara, Hiroo
Sato, Masayuki
Nagamine, Shun
Makioka, Kouki
Tanaka, Keiko
Ikeda, Yoshio
author_facet Kasahara, Hiroo
Sato, Masayuki
Nagamine, Shun
Makioka, Kouki
Tanaka, Keiko
Ikeda, Yoshio
author_sort Kasahara, Hiroo
collection PubMed
description A 45-year-old man was admitted due to tonic seizures, aphasia, disturbance of consciousness, and abnormal behavior. Because cerebral magnetic resonance imaging findings were normal and mild cerebrospinal fluid (CSF) pleocytosis was observed, autoimmune encephalitis was suspected. The presence of anti-N-methyl-D-aspartate (NMDA) receptor antibodies in the CSF was subsequently confirmed. (123)I-Iomazenil and cerebral blood flow single photon emission computed tomography (SPECT) revealed an abnormal uptake in the left frontotemporal region. Multimodal immunotherapy was administered, which remarkably improved the level of consciousness. Progressive reversibility of SPECT findings with clinical improvement suggested that the disorder-related functional deficits had been caused by anti-NMDA receptor antibodies.
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spelling pubmed-65489392019-06-17 Temporal Changes on (123)I-Iomazenil and Cerebral Blood Flow Single-photon Emission Computed Tomography in a Patient with Anti-N-methyl-D-aspartate Receptor Encephalitis Kasahara, Hiroo Sato, Masayuki Nagamine, Shun Makioka, Kouki Tanaka, Keiko Ikeda, Yoshio Intern Med Case Report A 45-year-old man was admitted due to tonic seizures, aphasia, disturbance of consciousness, and abnormal behavior. Because cerebral magnetic resonance imaging findings were normal and mild cerebrospinal fluid (CSF) pleocytosis was observed, autoimmune encephalitis was suspected. The presence of anti-N-methyl-D-aspartate (NMDA) receptor antibodies in the CSF was subsequently confirmed. (123)I-Iomazenil and cerebral blood flow single photon emission computed tomography (SPECT) revealed an abnormal uptake in the left frontotemporal region. Multimodal immunotherapy was administered, which remarkably improved the level of consciousness. Progressive reversibility of SPECT findings with clinical improvement suggested that the disorder-related functional deficits had been caused by anti-NMDA receptor antibodies. The Japanese Society of Internal Medicine 2019-02-01 2019-05-15 /pmc/articles/PMC6548939/ /pubmed/30713292 http://dx.doi.org/10.2169/internalmedicine.0987-18 Text en Copyright © 2019 by The Japanese Society of Internal Medicine https://creativecommons.org/licenses/by-nc-nd/4.0/ The Internal Medicine is an Open Access journal distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Kasahara, Hiroo
Sato, Masayuki
Nagamine, Shun
Makioka, Kouki
Tanaka, Keiko
Ikeda, Yoshio
Temporal Changes on (123)I-Iomazenil and Cerebral Blood Flow Single-photon Emission Computed Tomography in a Patient with Anti-N-methyl-D-aspartate Receptor Encephalitis
title Temporal Changes on (123)I-Iomazenil and Cerebral Blood Flow Single-photon Emission Computed Tomography in a Patient with Anti-N-methyl-D-aspartate Receptor Encephalitis
title_full Temporal Changes on (123)I-Iomazenil and Cerebral Blood Flow Single-photon Emission Computed Tomography in a Patient with Anti-N-methyl-D-aspartate Receptor Encephalitis
title_fullStr Temporal Changes on (123)I-Iomazenil and Cerebral Blood Flow Single-photon Emission Computed Tomography in a Patient with Anti-N-methyl-D-aspartate Receptor Encephalitis
title_full_unstemmed Temporal Changes on (123)I-Iomazenil and Cerebral Blood Flow Single-photon Emission Computed Tomography in a Patient with Anti-N-methyl-D-aspartate Receptor Encephalitis
title_short Temporal Changes on (123)I-Iomazenil and Cerebral Blood Flow Single-photon Emission Computed Tomography in a Patient with Anti-N-methyl-D-aspartate Receptor Encephalitis
title_sort temporal changes on (123)i-iomazenil and cerebral blood flow single-photon emission computed tomography in a patient with anti-n-methyl-d-aspartate receptor encephalitis
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6548939/
https://www.ncbi.nlm.nih.gov/pubmed/30713292
http://dx.doi.org/10.2169/internalmedicine.0987-18
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