Anti-N-methyl-D-aspartate receptor encephalitis associated with peripheral nerve injury: A case report

Fangjie Huang (Department of Neurology, Yuquan Hospital of Tsinghua University)
Shimei Zhou (Department of Neurology, Yuquan Hospital of Tsinghua University)
Mangsuo Zhao (Department of Neurology, Yuquan Hospital of Tsinghua University)
Jing Wang (Department of Neurology, Yuquan Hospital of Tsinghua University)
Jingfen Huang (Department of Neurology, Yuquan Hospital of Tsinghua University)
Hongzhi Guan (Department of Neurology, Peking Union Medical College Hospital)
Liyan Qiao (Department of Neurology, Yuquan Hospital of Tsinghua University)

Abstract


A patient with Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis presented with quadriplegia and multiple peripheral neuropathy with axonal lesion, confirmed by electrophysiological examination. The muscle strength in the limbs of the patient gradually recovered almost completely, accompanied by the reversal of neuroelectrophysiological symptoms, and the improvement of clinical manifestations, including consciousness, respiration and cognitive function. It was revealed that the neuropathy in NMDAR encephalitis involved motor or sensorimotor nerves more than pure sensory nerves. No autoantibodies were detectable, in contrast to other anti-NMDAR overlapping syndromes. Although the underlying mechanism remains unclear, it may be associated with autoimmune generalization. In conclusion, when patients with NMDAR encephalitis present with severe limb paralysis, the possibility of peripheral nerve damage should be considered.


Keywords


Anti-NMDAR encephalitis; Peripheral nerve disease; Multiple peripheral neuropathy; Autoimmune generalization; Overlapping syndrome

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References


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DOI: https://doi.org/10.30564/jams.v3i2.1766

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