A combination of midazolam and dexmedetomidine for anesthesia management in a patient with anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis: A case report

2021 ◽  
Vol 75 ◽  
pp. 110509
Author(s):  
Ming-Sung Yeh ◽  
Guan-Yu Chen ◽  
Chia-Heng Lin ◽  
Chia-Yu Lin
Keyword(s):  
Case Report ◽  
Anesthesia Management ◽  
Aspartate Receptor ◽  
Nmdar Encephalitis

scholarly journals Lyme Disease and Associated NMDAR Encephalitis: A Case Report and Literature Review

2021 ◽  
Vol 13 (4) ◽  
pp. 487-496
Author(s):  
Natalja Predkele ◽  
Jānis Mednieks
Keyword(s):  
Cerebrospinal Fluid ◽  
Case Report ◽  
Marked Improvement ◽  
Clinical Signs ◽  
Antibacterial Treatment ◽  
Speech Impairments ◽  
Igg Antibodies ◽  
Aspartate Receptor ◽  
Nmdar Encephalitis ◽  
Csf Findings

We present a case of a patient with positive N-methyl-D-aspartate receptor (NMDAR) IgG antibodies in their serum and cerebrospinal fluid (CSF) associated with neuroborreliosis. Clinically, the patient presented with symptoms of confusion, as well as behavioral and speech impairments. Regardless of antibacterial treatment, no significant improvement was achieved. Methylprednisolone provided a marked improvement in the patient’s clinical signs and CSF findings. The screening did not reveal any underlying neoplasm. Taking into account the marked clinical improvement after treatment with glucocorticosteroids, we suggest that NMDAR encephalitis is a possible autoimmune complication in neuroborreliosis patients requiring additional immunotherapy.

scholarly journals Recurrent anti-NMDAR encephalitis during pregnancy combined with two antibodies positive

2021 ◽  
Author(s):  
Hong Liu ◽  
Xiu Chen
Keyword(s):  
Case Report ◽  
Pregnant Woman ◽  
Young Women ◽  
Psychiatric Symptoms ◽  
Review Of The Literature ◽  
Double Antibody ◽  
Aspartate Receptor ◽  
Nmdar Encephalitis ◽  
Surface Antibody

AbstractAnti-N-methyl-d-aspartate receptor (NMDAR) encephalitis is an autoimmune synaptic encephalitis likely mediated by neuronal surface antibody. Clinically, it is characterized by a variety of neurological and psychiatric symptoms, predominantly affecting young women. Recurrent anti-NMDAR cases combined with double-antibody positive during pregnancy have not been reported. We report a 19-year-old pregnant woman with recurrent anti-NMDAR encephalitis and double-antibody positive. Through our case report and a review of the literature, we hope to heighten an awareness of anti-NMDAR encephalitis, particularly in a pregnant setting.

Recurrent Optic Neuritis in Paediatric Anti-N-Methyl-D-Aspartate Receptor (Anti-NMDAR) Encephalitis: Case Report and Literature Review

2022 ◽  
pp. 1-6
Author(s):  
Jinn Shian Chan ◽  
Masnon Nurul-Ain ◽  
Nor Fadhilah Mohamad ◽  
Wan Hazabbah Wan Hitam ◽  
Lakana Kumar Thavaratnam
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Optic Neuritis ◽  
Aspartate Receptor ◽  
Nmdar Encephalitis

scholarly journals Acute Psychosis Due to Anti-N-Methyl D-Aspartate Receptor Encephalitis Following COVID-19 Vaccination: A Case Report

2021 ◽  
Vol 12 ◽  
Author(s):  
Patrick Flannery ◽  
Ingrid Yang ◽  
Madjid Keyvani ◽  
George Sakoulas
Keyword(s):  
Cerebrospinal Fluid ◽  
Case Report ◽  
Nmda Receptor ◽  
Young Female ◽  
High Dose ◽  
Acute Psychosis ◽  
Neurological Assessment ◽  
Aspartate Receptor ◽  
Nmdar Encephalitis ◽  
History Of

Anti-N-methyl D-aspartate (NMDA) receptor (anti-NMDAR) encephalitis has been reported after SARS-CoV-2 infection, but not after SARS-CoV-2 vaccination. We report the first known case of anti-NMDAR encephalitis after SARS-CoV-2 immunization in a young female presenting with acute psychosis, highlighting a rare potential immunological complication of vaccination against SARS-CoV-2 that is currently being distributed worldwide. The patient presented initially with anxiety and hypochondriacal delusions which progressed to psychosis and catatonia but returned to baseline with aggressive immunomodulatory therapy consisting of intravenous immunoglobulin, high-dose glucocorticoids, and rituximab. This study highlights that the workup of acute psychosis should include establishing a history of recent vaccination followed by a thorough neurological assessment, including for anti-NMDAR antibodies in blood and cerebrospinal fluid.

scholarly journals Case Report: Overlapping Multiple Sclerosis With Anti-N-Methyl-D-Aspartate Receptor Encephalitis: A Case Report and Review of Literature

2020 ◽  
Vol 11 ◽  
Author(s):  
Ying Huang ◽  
Qian Wang ◽  
Silin Zeng ◽  
Yaqing Zhang ◽  
Liangyu Zou ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Case Report ◽  
Movement Disorders ◽  
Demyelinating Disease ◽  
Autoimmune Disorder ◽  
Review Of Literature ◽  
Aspartate Receptor ◽  
Nmdar Encephalitis ◽  
Relapsing Remitting ◽  
Relapsing Remitting Multiple Sclerosis

Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an autoimmune disorder mediated by NMDAR antibodies, typically manifesting as behavioral complaints, psychosis, seizures, movement disorders, hypoventilation, and autonomic dysfunction. In recent years, the predisposing factors and pathophysiological mechanisms of anti-NMDAR encephalitis have been tried to be clarified. It has been recognized that an overlap may be observed between anti-NMDAR encephalitis and inflammatory demyelinating disease. However, anti-NMDAR encephalitis is rarely associated with multiple sclerosis. Here, we describe a Chinese female patient diagnosed with relapsing remitting multiple sclerosis who developed anti-NMDAR encephalitis. Further, we discuss the previously reported literature.

Isolated Psychiatric Presentation of Anti N-Methyl-D-Aspartate Receptor Encephalitis: A Case Report

2016 ◽  
Vol 33 (S1) ◽  
pp. S524-S524
Author(s):  
P. Azevedo ◽  
F. Monteiro ◽  
A.P. Correia ◽  
A. Norton ◽  
A.M. Moreira
Keyword(s):  
Case Report ◽  
Psychiatric Symptoms ◽  
Brain Mri ◽  
Autoimmune Disorder ◽  
Oligoclonal Bands ◽  
Neurological Involvement ◽  
Sleep Cycle ◽  
Psychotic Episode ◽  
Aspartate Receptor ◽  
Nmdar Encephalitis

IntroductionAnti N-Methyl-D-Aspartate receptor (NMDAR) encephalitis is an autoimmune disorder with a presentation that includes acute behavioral changes, psychosis, cognitive impairment and autonomic instability. In some cases, there are isolated psychiatric symptoms without neurological involvement.AimsTo raise awareness of the disorder among psychiatrists, considering it a differential diagnosis in a first psychotic episode since a prompt diagnosis and treatment can dramatically affect the outcome.ObjectivesTo summarize the latest literature about this field and to present a case report.MethodsA brief review of the latest literature was performed on PubMed using the keywords “anti N-methyl-D-aspartate receptor encephalitis”, “anti-NMDA encephalitis”, “psychiatric symptoms”.ResultsA 20-year-old male was admitted to our inpatient unit with bizarre delusions of grandious and religious content, somatic hallucinations, sleep cycle inversion and strange behaviour. These symptoms had been present for 1 week and remitted after 10 days of treatment with risperidone. On follow-up, he developed anhedonia, apathy and blunt affect. Brain MRI showed multiple hyperintense changes in T2 and T2-FLAIR, highly suggestive of demyelinating lesions. The cerebrospinal fluid showed mild lymphocytic pleocytosis, mildly increased proteins, oligoclonal bands and anti-NMDAR antibodies of intrathecal production. He was treated with corticoids and the antipsychotic was discontinued. No neurologic symptoms were ever present.ConclusionThis is an atypical case of anti-NMDAR encephalitis because of its isolated psychiatric presentation. Most patients develop neurological symptoms 2 to 3 weeks after onset of psychiatric symptoms. Monosymptomatic syndromes arise in less than 5% of patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Anti-N-methyl-D-aspartate receptor encephalitis associated with peripheral nerve injury: A case report

2020 ◽  
Vol 3 (2) ◽  
pp. 12
Author(s):  
Fangjie Huang ◽  
Shimei Zhou ◽  
Mangsuo Zhao ◽  
Jing Wang ◽  
Jingfen Huang ◽  
...  
Keyword(s):  
Case Report ◽  
Peripheral Nerve ◽  
Peripheral Nerve Injury ◽  
Clinical Manifestations ◽  
Underlying Mechanism ◽  
Sensory Nerves ◽  
Peripheral Nerve Damage ◽  
Aspartate Receptor ◽  
Nmdar Encephalitis ◽  
Electrophysiological Examination

A patient with Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis presented with quadriplegia and multiple peripheral neuropathy with axonal lesion, confirmed by electrophysiological examination. The muscle strength in the limbs of the patient gradually recovered almost completely, accompanied by the reversal of neuroelectrophysiological symptoms, and the improvement of clinical manifestations, including consciousness, respiration and cognitive function. It was revealed that the neuropathy in NMDAR encephalitis involved motor or sensorimotor nerves more than pure sensory nerves. No autoantibodies were detectable, in contrast to other anti-NMDAR overlapping syndromes. Although the underlying mechanism remains unclear, it may be associated with autoimmune generalization. In conclusion, when patients with NMDAR encephalitis present with severe limb paralysis, the possibility of peripheral nerve damage should be considered.

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