Overlapping demyelinating syndrome and anti- N-methyl-d-aspartate receptor encephalitis with seizures

Olga Taraschenko; Rana Zabad

doi:10.1016/j.ebr.2019.100338

Overlapping demyelinating syndrome and anti- N-methyl-d-aspartate receptor encephalitis with seizures

Epilepsy Behav Rep. 2019 Oct 25:12:100338. doi: 10.1016/j.ebr.2019.100338. eCollection 2019.

Authors

Olga Taraschenko¹, Rana Zabad¹

Affiliation

¹ Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, United States of America.

Abstract

Anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis, the most recognized type of autoimmune encephalitis, manifests with rapid cognitive decline, psychosis, and seizures that develop in 78-86% of patients. Recently, anti-NMDAR encephalitis was reported in association with demyelinating diseases which are accompanied by a characteristic clinical phenotype, imaging abnormalities, and the presence of antibodies against myelin oligodendrocyte glycoprotein (MOG-IgG) in bodily fluids. The patient presented herein suffered from bilateral optic neuritis followed by recurrent encephalitis with focal seizures and demonstrated anti-NMDAR and MOG-IgGs in the cerebrospinal fluid and serum, respectively. Her symptoms responded to immunotherapy and antiseizure medication. The recognition of the novel syndrome of MOG antibody-associated demyelination (MOGAD), encompassing the overlapping anti-NMDAR encephalitis and other MOG-IgG associated disorders, is important for the successful management of these patients.

Keywords: Anti-NMDA receptor encephalitis; Autoantibodies; Autoimmune encephalitis; Demyelinating disease; Myelin oligodendrocyte glycoprotein; Seizures.

Publication types

Case Reports