We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Bi-insular cortical involvement in anti-NMDA-receptor encephalitis - a case report.
- Authors
Hegen, Harald; Uprimny, Christian; Grams, Astrid; Virgolini, Irene; Ramberger, Melanie; Beer, Ronny; Helbok, Raimund; Pfausler, Bettina; Schmutzhard, Erich
- Abstract
<bold>Background: </bold>Anti-NMDA-receptor encephalitis is an immune-mediated inflammatory disorder of the central nervous system. Brain MRI is unremarkable in at least 50% of patients and highly variable in the remaining patients with signal abnormalities in different brain regions. Only scarce reports exist on other imaging modalities. <bold>Case Presentation: </bold>A 31-year-old woman sub-acutely developed psychosis, behavioural changes, amnesia, alternating states of agitation and mutism, fever and epileptic seizures. Clinically suspected diagnosis of anti-NMDA-receptor encephalitis was confirmed by the detection of anti-NMDA receptor antibodies in CSF and serum. During the acute phase, brain MRI abnormalities were found in both insular cortices and hippocampi, whereas F(18)-FDG-PET showed hypermetabolism bilaterally in insular and prefrontal cortex. After resection of the underlying ovarian teratoma and with multimodal immunotherapy the patient substantially improved reaching a modified Rankin Scale score of 2 after 3 months. At follow-up, both hippocampi were still affected on MRI, whereas insular cortex appeared normal; however, both regions showed prominent glucose hypometabolism. <bold>Conclusions: </bold>Here, we report bi-insular cortical abnormalities on MRI and F(18)-FDG-PET in a patient with anti-NMDA-receptor encephalitis during the acute phase and after clinical improvement.
- Subjects
METHYL aspartate receptors; ENCEPHALITIS; MAGNETIC resonance imaging of the brain; INSULAR cortex; HIPPOCAMPUS (Brain); TEMPORAL lobe; FRONTAL lobe; CEREBROSPINAL fluid
- Publication
BMC Neurology, 2016, Vol 16, p1
- ISSN
1471-2377
- Publication type
journal article
- DOI
10.1186/s12883-016-0653-9