title: Ophthalmoplegia and flaccid paraplegia in a patient with anti-NMDA receptor encephalitis: a case report and literature review.
abstract: We herein report the case of a 26-year-old woman with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis presenting with ophthalmoplegia and flaccid paraplegia. She developed disorientation and hallucination after fever and vomiting. Hypothermia, hypoventilation, hypertension, paralytic ileus and hyponatremia were present. Neurological examination showed mild consciousness disturbance and bilateral ophthalmoplegia on admission, flaccid paraplegia with leg areflexia on Day 4. Anti-NMDAR antibodies were detected in the serum and cerebrospinal fluid samples. Motor nerve conduction velocity was decreased in the tibial and peroneal nerves. F-wave amplitudes were reduced in the tibial nerve. MRI disclosed lesions in the callosal splenium, hippocampus and cerebral subarachnoid regions. In addition to various encephalitic symptoms, physicians should pay more attention to peripheral nerve damage in patients with anti-NMDAR encephalitis.
authors: Department of Neurology, Toho University Omori Medical Center, Japan.
authors: Yuichi
authors: Y
authors: Ishikawa
authors: Ken
authors: K
authors: Ikeda
authors: Kiyoko
authors: K
authors: Murata
authors: Takehisa
authors: T
authors: Hirayama
authors: Takanori
authors: T
authors: Takazawa
authors: Masaru
authors: M
authors: Yanagihashi
authors: Osamu
authors: O
authors: Kano
authors: Kiyokazu
authors: K
authors: Kawabe
authors: Yukitoshi
authors: Y
authors: Takahashi
authors: Yasuo
authors: Y
authors: Iwasaki
mesh_terms: D000328:Adult; D060426:Anti-N-Methyl-D-Aspartate Receptor Encephalitis / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D020275:Guillain-Barre Syndrome / Q000150:complications / Q000175:diagnosis / Q000473:pathology; D006801:Humans; D009886:Ophthalmoplegia / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D010264:Paraplegia / Q000150:complications / Q000175:diagnosis* / Q000473:pathology