[Subacute encephalitis associated with anti-glutamate receptor antibodies: serial studies of MRI, 1H-MRS and SPECT].
A 32-year-old man who had experienced fever and a pulsating headache of the right occipital region for a month and a transient left hemianopia and numbness in the left arm two weeks prior to presentation was admitted to our hospital because of a seizure. Fluid-attenuated inversion recovery and diffusion-weighted magnetic resonance imaging (MRI) showed high-intensity signals, without reduction of apparent diffusion coefficient value, in the right temporo-occipital cortices. Proton MR spectroscopy (1H-MRS) indicated a decrease in N-acetylaspartate, and single-photon emission CT (SPECT) showed hyperperfusion in the right temporo-occipital territory. An examination of the cerebrospinal fluid showed an elevation of mononuclear cells and the presence of anti-glutamate epsilon2 receptor antibodies. All abnormalities shown by these imaging techniques were normalized in the clinical course. This report suggests that MRI, 1H-MRS and SPECT studies were useful in understanding the pathogenesis of encephalitis associated with glutamate receptor antibodies.
Yamamoto
Shiro
S
Cerebrovascular Division, Department of Medicine, Yodogawa Christian Hospital.
Koide
Yasumichi
Y
Fujiwara
Mito
M
Nakazawa
Kenichiro
K
Takahashi
Yukitoshi
Y
Hara
Hitoshi
H
D000328:Adult; D001323:Autoantibodies; D004660:Encephalitis / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology*; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage; D020551:Pulse Therapy, Drug; D016194:Receptors, N-Methyl-D-Aspartate / Q000276:immunology*; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome
D001323:Autoantibodies; C121001:NR2B NMDA receptor; D016194:Receptors, N-Methyl-D-Aspartate; D008775:Methylprednisolone