title: [Encephalitis associated with positive anti-GluR antibodies showing abnormal appearance in basal ganglia, pulvinar and gray matter on MRI--case report].
abstract: We treated a 25-year-old woman with encephalitis. Following delivery, the patient developed fever, consciousness disturbance, cognitive dysfunction, and progressive motor dysfunction. In addition, mycobacterium tuberculosis was found in the lung, though there was no evidence of such infection in the central nervous system. Cerebrospinal fluid analysis revealed a slight elevation of mononuclear cells with a normal protein level indicating a possible viral infection. We could not find the origin of the infection, though the serum anti-glutamate epsilon2 receptor antibody was positive. Intravenous administration of methylprednisolone (1000 mg/day for 3 days) was temporarily effective for improvement of the clinical signs and symptoms. However, she finally demonstrated rapid deterioration resulting in death. Diffusion-weighted brain magnetic resonance imaging demonstrated abnormal high intensity lesions in the bilateral pulvinar and gray matter, with an abnormal appearance mimicking pulvinar sign.
authors.affiliation: Division of Neurology, National Hospital Organization Toneyama National Hospital.
authors.forename: Saito
authors.initials: S
authors.lastname: Toshio
authors.forename: Tomoko
authors.initials: T
authors.lastname: Saito
authors.forename: Yukitoshi
authors.initials: Y
authors.lastname: Takahashi
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Kokunai
authors.forename: Harutoshi
authors.initials: H
authors.lastname: Fujimura
mesh_terms: D000328:Adult; D001323:Autoantibodies / Q000097:blood*; D001479:Basal Ganglia / Q000473:pathology*; D001921:Brain / Q000473:pathology*; D004660:Encephalitis / Q000276:immunology* / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D011247:Pregnancy; D011644:Puerperal Disorders; D020649:Pulvinar / Q000473:pathology*; D016194:Receptors, N-Methyl-D-Aspartate / Q000276:immunology*
chemical_list: D001323:Autoantibodies; C121001:NR2B NMDA receptor; D016194:Receptors, N-Methyl-D-Aspartate