Autoimmune encephalitis is a recently described pathology as inflammatory disease of the central nervous system, previously characterized as a paraneoplastic syndrome. However, advances in technology have allowed to categorize it as an entity, with an specific physiopathology, and a clinical presentation based on the developed auto-antibody, but, the wide clinical presentation, the insidious development of the symptoms, the mimic with other pathologies and the lack of knowledge of this condition in the emergency room and hospitalization services, does not permit to diagnose this condition, leading to potentially fatal complications. We report the case of a 26-years-old female with autoimmune encephalitis, and a literature review regarding this topic.
Autoimmune encephalitis
Encefalitis Límbica Autoinmune Asociada a Anticuerpos LGI1. Autoimmune Limbic Encephalitis Associated With LGI1 Antibodies.
Introduction: Leucine rich glioma inactivated protein 1 (LGI1) antibody encephalitis is a rare disease characterized by subacute memory impairment, behavioral disorders and epileptic seizures. Even most cases have a good outcome, residual cognitive deficits are common.
Case report. A 76 years old woman who started with acute onset generalized tonic – clonic seizures and subsequent impaired level of consciousness. Antiepileptic treatment was started with slight clinical improvement. In magnetic resonance imaging performed during admission left hippocampal hyperintensity was seen in T2 and T2-FLAIR sequences. As autoimmune limbic encephalitis was suspected, immunomodulatory treatment with intravenous corticosteroids and immunoglobulins was started with clinical improvement. Afterwards, anti–LGI1 antibodies were positive in cerebrospinal fluid testing.
Conclusions. Anti–LGI1 antibody related encephalitis can produce different neurological manifestations and diverse onset, even acute. Early immunomodulatory treatment is important to improve both clinical manifestations and long–term outcome.
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Encefalitis Autoinmune Anti-Receptor NMDA Reporte de Caso Clínico y Revisión de Literatura. Anti-NMDA Receptor Encephalitis Case Report And Review Of Literature
Anti-NMDA Antibody encephalitis is an autoimmune entity characterized by the presence of autoantibodies against NMDA receptors. It is important to have in mind this entity, because it can be misdiagnosed initially due to its symptoms erroneously attributed to a psychiatric disorder, and diagnosis and treatment may be delayed. In this case report we describe a young woman who entered with neurological – psychiatric symptoms that simulate an acute schizophrenia and finally was diagnosed of autoimmune encephalitis.
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Encefalitis Autoinmune Antirreceptor de NMDA: Reporte de un Caso y Revisión de la Literatura. Anti-NMDA Receptor Encephalitis: Case Report And Review Of Literature.
Encephalitis caused by N-methyl-D-aspartate receptor antibodies is associated with auto antibodies against the heteromeric NR1/NR2 units of NMDA receptors. This type of encephalitis occurs more commonly in young adults, most of them women, and shows a good response to known treatments. Clinical features include neuropsychiatric manifestations, advancing through a series of stages up to a gradual recovery. This type of encephalitis can be associated with the presence, or lack thereof, lesions caused by tumors. It can easily be mistaken with infectious encephalitis, therefore is important to recognize its clinical features for an appropriate diagnosis and treatment in order to prevent higher morbidity and mortality. In this article, I describe a case study of autoimmune encephalitis caused by NMDA receptor antibodies in a twenty-two year old man, admitted to the Enrique Garcés Hospital in Quito-Ecuador, and I make a literature review on this pathology.
