Open AccessAnti-N-methyl-D-aspartate receptor encephalitis associated with peripheral nerve injury: A case report
Author(s) -
Fangjie Huang,
Shimei Zhou,
Mangsuo Zhao,
Jing Wang,
Jingfen Huang,
Hongzhi Guan,
Liyan Qiao
Publication year - 2020
Publication title -
journal of advances in medicine science
Language(s) - English
Resource type - Journals
eISSN - 2591-7617
pISSN - 2591-7609
DOI - 10.30564/jams.v3i2.1766
Subject(s) - encephalitis , autoantibody , medicine , nmda receptor , peripheral neuropathy , peripheral , autoimmune encephalitis , lesion , peripheral nerve injury , paralysis , guillain barre syndrome , pathology , peripheral nervous system , sensory system , neuroscience , peripheral nerve , receptor , immunology , central nervous system , psychology , anatomy , surgery , endocrinology , antibody , virus , diabetes mellitus
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.