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Bi-insular cortical involvement in anti-NMDA-receptor encephalitis - a case report.
- Source :
- BMC Neurology; 8/8/2016, Vol. 16, p1-4, 4p, 2 Diagrams
- Publication Year :
- 2016
-
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. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 14712377
- Volume :
- 16
- Database :
- Complementary Index
- Journal :
- BMC Neurology
- Publication Type :
- Academic Journal
- Accession number :
- 117328599
- Full Text :
- https://doi.org/10.1186/s12883-016-0653-9