Treatment-responsive subacute limbic encephalitis and NMDA receptor antibodies in a man.

摘要: Disturbances of memory, behavior, cognition, and seizures can result from immune-mediated encephalitides. These disorders be paraneoplastic or not may associate with several antibodies.1 Recently, a treatment-responsive encephalitis that associates antibodies to NR1/NR2 heteromers the NMDA receptor (NMDAR) was reported.2 Patients were young women teratomas, usually ovary, who presented prominent psychiatric symptoms, less frequently features limbic encephalitis. We report man heteromers. ### Case report. For 3 months this 53-year-old had progressive short-term memory deficits disorientation forced him leave his job. During month before hospital admission he multiple episodes compatible partial complex seizures. He no past medical history interest. The neurologic examination only revealed impairment temporal orientation. Blood cell count, general chemistry, B12, folic acid, thyroid function test, thyroglobulin antibodies, RPR, Lyme serology, double stranded DNA, SSA/Ro SSB/La unrevealing. CSF analysis showed 5 WBC/μL (100% lymphocytes) normal glucose protein concentration. Serum disclosed same oligoclonal IgG bands. Paraneoplastic antineuronal VGKC negative. EEG demonstrated bilateral lobe epileptic activity. MRI brain noncontrast enhancing T2 FLAIR hyperintensities involving medial aspect lobes nonspecific in frontal (figure, A). Ultrasound testis, CT chest, abdomen …