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- W2997503502 abstract "Anti-NMDAR encephalitis is one of the most frequent neuropsychiatric disorders which can occur with or without associated cancer. A 21 years old Filipino women presented with fever and seizure, she was treated as case of encephalitis with empiric treatment. She became disoriented and had motor restlessness. LP was inconclusive, however showed high protein. EEG was encephalopathic, and MRI had subtle changes. Her condition deteriorated; she was catatonic, mutism and still feverish. Repeated MRI brain FLAIR showed mesial temporal hyperintensity bilaterally. EEG showed slowing, non-epileptiform features. Repeat CSF showed 11 oligoclonal bands. She was started on IV methylprednisolone and IVIG. While on treatment, she had orofacial dyskinesia, drooling of saliva, and autonomic dysfunction features: tachycardia, hypertension and fever. CT abdomen/pelvis were normal. She received 1st course of plasmapheresis. Her condition kept worsening, she developed central hypoventilation syndrome and was mechanically ventilated. She had 2nd course of plasmapheresis. MRI pelvis did not reveal any ovarian tumor. She had tracheostomy and PEG tube insertion. She was started on rituximab and cyclophosphamide. Follow-up MRI showed lesion resolution. Serum came positive for anti-NMDAR Ab and AChR Ganglionic neuronal Ab. Upon discharge, patient was ambulating without support, feeding orally and communicating non-verbally. This patient showed all 8 groups of symptoms of anti-NMDAR encephalitis (Table 1). Initial presentation made the diagnosis challenging. Improvement was noted with the second line of treatment. Organic causes of psychiatric symptoms should be considered. Close monitoring may reveal additional clues to reach diagnosis." @default.
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- W2997503502 date "2019-10-01" @default.
- W2997503502 modified "2023-09-25" @default.
- W2997503502 title "Diagnosis of anti-NMDAR encephalitis requires high index of suspicion: Lessons from a case" @default.
- W2997503502 doi "https://doi.org/10.1016/j.jns.2019.10.889" @default.
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