title: An Atypical Case of Anti-NMDA Receptor Encephalitis: Predominant Parkinsonism and Persisting Micrographia without Oro-facial Dyskinesia.
abstract: We describe the case of a 46-year-old man with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis with prominent parkinsonism. The patient presented with psychiatric symptoms followed by epileptic seizure and parkinsonism including micrographia. Magnetic resonance imaging (MRI) revealed lesions in the bilateral medial temporal lobes and basal ganglia on fluid-attenuated inversion recovery images. His symptoms and MRI findings were ameliorated by immunotherapy but then relapsed. After retreatment, his parkinsonism gradually improved except for the micrographia. This is an atypical case of anti-NMDAR encephalitis in that the patient showed prominent and refractory parkinsonism, thus indicating that the clinical diversity of anti-NMDAR encephalitis is greater than expected.
authors.affiliation: Department of Neurology and Anti-aging Medicine, National Defense Medical College, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Kadoya
authors.forename: Akiko
authors.initials: A
authors.lastname: Kadoya
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Onoue
authors.forename: Katsunori
authors.initials: K
authors.lastname: Ikewaki
authors.forename: Kenichi
authors.initials: K
authors.lastname: Kaida
mesh_terms: D000328:Adult; D060426:Anti-N-Methyl-D-Aspartate Receptor Encephalitis / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D020820:Dyskinesias; D006801:Humans; D007167:Immunotherapy; D008279:Magnetic Resonance Imaging; D008297:Male; D020734:Parkinsonian Disorders / Q000150:complications* / Q000503:physiopathology*