边缘脑炎
脑脊液
病理
医学
脑炎
肌阵挛
神经油
免疫学
内科学
病毒
中枢神经系统
麻醉
作者
Denison Pedrosa,João Henrique Fregadolli Ferreira,René de Araújo Gleizer,Rafael Bernhart Carra,Rachel Marin Carvalho,Verena Endmayr,Romana Höftberger,Lívia Almeida Dutra
出处
期刊:Practical Neurology
[BMJ]
日期:2024-02-29
卷期号:: pn-004089
标识
DOI:10.1136/pn-2024-004089
摘要
A 30-year-old woman had 5 days of visual hallucinations, nystagmus, memory impairment and mutism. On examination, she was disorientated with reduced attention span, gaze-evoked nystagmus, paratonia and abnormal frontal reflexes. Cerebrospinal fluid (CSF) showed 80 cells, protein 0.41 g/L and glucose 3.2 mmol/L (plasma glucose 5.0 mmol/L). MR scan of the brain showed involvement of limbic and extra-limbic regions and brainstem. Commercial cell-based assays were negative, but tissue-based assays showed neuropil staining, and cell-based assays for anti-metabotropic glutamate receptor 5 (mGluR5) antibodies were positive in serum and CSF. Six months later, she was diagnosed with Hodgkin’s lymphoma. This case emphasises the broader clinical spectrum of anti-mGluR5 encephalitis, challenging its initial characterisation as Ophelia syndrome. It underscores the significance of interpreting commercial cell-based assays and advocates for tissue-based assay testing followed by cell-based assay testing in serum and CSF for diagnosing rare autoimmune encephalitis.
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