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- W2411241445 abstract "Objective: To highlight the importance of considering anti-NMDA receptor encephalitis in an elderly patient presenting with a dementia syndrome.Background: Anti-NMDA-receptor encephalitis is an immune-mediated syndrome that has increasingly gained attention. While it is often considered in younger patients presenting with subacute development of otherwise-unexplained psychiatric manifestations, the elderly too are at risk for development of this potentially treatable disease.Design/Methods: We report the case of a 76 year old male with metastatic hormone sensitive prostate adenocarcinoma. Approximately 11 months before presentation, he developed short term memory impairment. This continued for 6 months, when he progressed to develop confusion, disorientation, and incoherent, illogical speech, along with visual hallucinations and widely varying states of alertness. He had dysautonomia with orthostasis, requiring pacemaker placement. On exam, he had asymmetrically increased tone. A degenerative process, such as DLB or MSA, was suspected given his age, symptoms, and subacute to chronic progression. Work-up included an unremarkable CT of the brain. An MRI was not performed given pacemaker incompatibility. EEG did not reveal epileptiform activity. CSF analysis demonstrated mild pleocytosis (12) and an elevated IgG index (1.02). CSF NMDA-R Ab cell-binding assay was positive, and immunofixation titer was highly positive (1:128). He was diagnosed with anti-NMDA receptor encephalitis.Results: At the time of this submission, the patient is receiving treatment with intravenous methylprednisolone and immunoglobulin therapy.Conclusions: Anti-NMDA Receptor Encephalitis should be considered in patients of all ages. It has been reported in infants as young as 8 months old, and in adults as old as 75 years of age. Literature review suggests this may be the oldest reported case of NMDA-receptor encephalitis. Given the treatable nature of the disease, it is a diagnosis that should be given careful consideration even in elderly patients with neuropsychiatric manifestations. Disclosure: Dr. Ali has nothing to disclose. Dr. Baron has nothing to disclose." @default.
- W2411241445 created "2016-06-24" @default.
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- W2411241445 date "2016-04-05" @default.
- W2411241445 modified "2023-09-26" @default.
- W2411241445 title "Encephalitis in the Elderly: NMDA-R Encephalitis Mistaken for Dementia (P6.209)" @default.
- W2411241445 hasPublicationYear "2016" @default.
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