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Extensive myelitis associated with anti-NMDA receptor antibodies.

Abstract : BACKGROUND: Encephalitis with anti-N-methyl-D-aspartate receptor antibodies (anti-NMDAR-Ab) is a rapid-onset encephalitis including psychosis, seizures, various movement disorders and autonomic system disturbances. CASE PRESENTATION: We report a very unusual case of extensive myelitis associated with anti-NMDAR-Ab. MRI also revealed a hyperintense T2 lesion, non-suggestive of MS, which progressively extended, associated with periventricular gadolinium enhancement visualized on brain MRI. Ophthalmological evaluation showed subclinical right optic neuritis. The absence of anti-AQP4 antibody argued against neuromyelitis optica spectrum disorder. A slight psychomotor slowing prompted us to search for various causes of autoimmune encephalitis. Anti-NMDAR-Ab was found in cerebrospinal fluid. CONCLUSION: In patients with extensive myelitis who are seronegative for anti-AQP4 antibodies, and after other classical causes have been excluded, the hypothesis of atypical anti-NMDAR-Ab encephalitis should also be considered.
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Submitted on : Monday, January 6, 2014 - 5:06:32 AM
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Olivier Outteryck, Guillaume Baille, Jérôme Hodel, Marianne Giroux, Arnaud Lacour, et al.. Extensive myelitis associated with anti-NMDA receptor antibodies.. BMC Neurology, BioMed Central, 2013, 13 (1), pp.211. ⟨10.1186/1471-2377-13-211⟩. ⟨inserm-00923927⟩

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