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Anti-NMDA Receptor Encephalitis in a Pregnant Woman.

Kim J, Park SH, Jung YR, Park SW, Jung DS - J Epilepsy Res (2015)

Bottom Line: It has variable clinical manifestations and treatment responses.Sometimes it is misdiagnosed as a psychiatric disorder or viral encephalitis.We report a case of anti-NMDA receptor encephalitis in a pregnant woman who presented with abnormal behavior, epileptic seizure, and hypoventilation.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, Pusan National University Hospital and Pusan National University School of Medicine, and BioMedical Research Institute, Pusan National University Hospital, Busan, Korea.

ABSTRACT
Anti N-methyl-D-aspartate (NMDA) receptor encephalitis is one of the most common types of autoimmune synaptic encephalitis. Anti-NMDA receptor encephalitis commonly occurs in young women with ovarian teratoma. It has variable clinical manifestations and treatment responses. Sometimes it is misdiagnosed as a psychiatric disorder or viral encephalitis. To the best of our knowledge, anti-NMDA receptor encephalitis is a rare condition in pregnant women. We report a case of anti-NMDA receptor encephalitis in a pregnant woman who presented with abnormal behavior, epileptic seizure, and hypoventilation.

No MeSH data available.


Related in: MedlinePlus

Brain MRI. (A) Initial brain MRI was normal. (B) Follow-up MRI, ten months after the onset of symptoms, shows diffuse brain atrophy and bilateral hippocampal atrophy compared with the initial brain MRI (A) on fluid attenuation inversion recovery (FLAIR) and T2 weighted images (T2WI).
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f1-er-5-1-29: Brain MRI. (A) Initial brain MRI was normal. (B) Follow-up MRI, ten months after the onset of symptoms, shows diffuse brain atrophy and bilateral hippocampal atrophy compared with the initial brain MRI (A) on fluid attenuation inversion recovery (FLAIR) and T2 weighted images (T2WI).

Mentions: A 28-year-old woman presented with abnormal behavior, hypoventilation, and epileptic seizure. At the time, she was pregnant (gestational age 7 weeks + 4 days). She had mild fever, headache, and sleep disturbance for the previous two weeks. She had neither previous medical history nor medication. An emergency brain computed tomography (CT) scan, brain magnetic resonance imaging (MRI), and a lumbar puncture were performed while the patient was in the emergency room. Emergency CT scan and brain MRI were normal (Fig. 1A). Cerebrospinal fluid (CSF) analysis revealed pressure of 230 mmH2O, 162 white cells per mm3 (92% lymphocytes), 48 mg/dl glucose, 46.2 mg/dl proteins with no organisms on the Gram stain, and negative CSF cultures. We initially considered her symptoms were indicating a viral encephalitis, and empiric therapy with acyclovir (10 mg/Kg/8 hr) was thus initiated. Transabdominal ultrasonography was performed to evaluate the fetal status in the emergency room. The fetus was healthy; however, we could not detect ovarian teratoma from the transabdominal ultrasonography.


Anti-NMDA Receptor Encephalitis in a Pregnant Woman.

Kim J, Park SH, Jung YR, Park SW, Jung DS - J Epilepsy Res (2015)

Brain MRI. (A) Initial brain MRI was normal. (B) Follow-up MRI, ten months after the onset of symptoms, shows diffuse brain atrophy and bilateral hippocampal atrophy compared with the initial brain MRI (A) on fluid attenuation inversion recovery (FLAIR) and T2 weighted images (T2WI).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4494994&req=5

f1-er-5-1-29: Brain MRI. (A) Initial brain MRI was normal. (B) Follow-up MRI, ten months after the onset of symptoms, shows diffuse brain atrophy and bilateral hippocampal atrophy compared with the initial brain MRI (A) on fluid attenuation inversion recovery (FLAIR) and T2 weighted images (T2WI).
Mentions: A 28-year-old woman presented with abnormal behavior, hypoventilation, and epileptic seizure. At the time, she was pregnant (gestational age 7 weeks + 4 days). She had mild fever, headache, and sleep disturbance for the previous two weeks. She had neither previous medical history nor medication. An emergency brain computed tomography (CT) scan, brain magnetic resonance imaging (MRI), and a lumbar puncture were performed while the patient was in the emergency room. Emergency CT scan and brain MRI were normal (Fig. 1A). Cerebrospinal fluid (CSF) analysis revealed pressure of 230 mmH2O, 162 white cells per mm3 (92% lymphocytes), 48 mg/dl glucose, 46.2 mg/dl proteins with no organisms on the Gram stain, and negative CSF cultures. We initially considered her symptoms were indicating a viral encephalitis, and empiric therapy with acyclovir (10 mg/Kg/8 hr) was thus initiated. Transabdominal ultrasonography was performed to evaluate the fetal status in the emergency room. The fetus was healthy; however, we could not detect ovarian teratoma from the transabdominal ultrasonography.

Bottom Line: It has variable clinical manifestations and treatment responses.Sometimes it is misdiagnosed as a psychiatric disorder or viral encephalitis.We report a case of anti-NMDA receptor encephalitis in a pregnant woman who presented with abnormal behavior, epileptic seizure, and hypoventilation.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, Pusan National University Hospital and Pusan National University School of Medicine, and BioMedical Research Institute, Pusan National University Hospital, Busan, Korea.

ABSTRACT
Anti N-methyl-D-aspartate (NMDA) receptor encephalitis is one of the most common types of autoimmune synaptic encephalitis. Anti-NMDA receptor encephalitis commonly occurs in young women with ovarian teratoma. It has variable clinical manifestations and treatment responses. Sometimes it is misdiagnosed as a psychiatric disorder or viral encephalitis. To the best of our knowledge, anti-NMDA receptor encephalitis is a rare condition in pregnant women. We report a case of anti-NMDA receptor encephalitis in a pregnant woman who presented with abnormal behavior, epileptic seizure, and hypoventilation.

No MeSH data available.


Related in: MedlinePlus