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Liu et al. Neuroimmunol Neuroinflammation 2016;3:257-9 Neuroimmunology and
DOI: 10.20517/2347-8659.2016.28
Neuroinflammation

www.nnjournal.net
Case Report Open Access

A case of anti-NMDA receptor encephalitis

with ADEM-like clinical/MR findings

Jia Liu, Huan Yi, Li Xu, Min Li, Xuan Wang, Fu-Hua Peng

Multiple Sclerosis Center, Department of Neurology, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, Guangdong, China.
Correspondence to: Dr. Fu-Hua Peng, Multiple Sclerosis Center, Department of Neurology, the Third Affiliated Hospital of Sun Yat-Sen
University, Tian He Road No. 600, Guangzhou 510630, Guangdong, China. E-mail: pfh93@163.com

How to cite this article: Liu J, Yi H, Xu L, Li M, Wang X, Peng FH. A case of anti-NMDA receptor encephalitis with ADEM-like clinical/MR
findings. Neuroimmunol Neuroinflammation 2016;3:257-9.
ABSTRACT

Article history: In recent years, anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis overlapping with
Received: 05-06-2016 demyelinating disorders has attracted more and more attention. The case is about a 52-year-
Accepted: 20-10-2016 old woman with anti-NMDAR encephalitis presenting acute disseminated encephalomyelitis
Published: 18-11-2016 (ADEM)-like clinical/magnetic resonance (MR) findings. Here, the authors report this case
and briefly review her MR evolution and the conditions of her prognosis. The recognition that
Key words: patients with anti-NMDAR encephalitis may have demyelinating disorders, simultaneously
N-methyl-D-aspartate, or sequentially, is important. Otherwise, a high dose of steroid treatment with several courses
encephalitis, could obtain good effect, even if given in the late phase.
acute disseminated
encephalomyelitis

INTRODUCTION encephalomyelitis (ADEM)-like clinical/magnetic
resonance (MR) findings is rare.
Anti-N-methyl-D-aspartate receptor (NMDAR)
encephalitis is a severe autoimmune encephalitis. CASE REPORT
Patients usually present with psychiatric/behavioral
change, dyskinesia, memory deficit, autonomic A 52-year-old Chinese woman presented with fever,
instability, disorders of consciousness, and even life- headaches, neck rigidity, and apathy. She was
threatening conditions. [1,2] Anti-NMDAR encephalitis treated successively with intravenous acyclovir and
has been recognized in patients of all ages, but dexamethasone (DXM) in small amounts (10 mg/day)
more frequently in children, with or without teratoma, to control the symptoms as if they were from viral
and young adults. In recent years, anti-NMDAR meningitis. Over the following weeks, the patient
[3]
encephalitis overlapping with demyelinating disorders became progressively confused and had difficulty with
has attracted more and more attention. However, anti- walking and urinary and fecal incontinence. She was
NMDAR encephalitis showing acute disseminated then transferred to our hospital. A clinical diagnosis

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