Anti-NMDAR encephalitis during the remission of optic neuritis: A case report and literature review

doi:10.3969/j.issn.1004-583X.2025.05.012

Abstract

Abstract:

Objective To investigate the clinical characteristics of anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis during the remission of optic neuritis. Methods A case of anti-NMDAR encephalitis during the remission of optic neuritis was retrospectively analyzed, and the published literatures at home and abroad were reviewed. Results A 28-year-old female presented with episodic unconsciousness, convulsions of the limbs and auditory hallucinations for 2 hours and 40 minutes. Epilepsy seizures occurred again during the hospitalization period. The patient had a history of epileptic seizures during the dosage reduction of hormone shock therapy for optic neuritis. Cranial magnetic resonance imaging showed marginal lobe encephalitis and meningitis. Serum and cerebrospinal fluid tests were positive for the anti-NMDAR1 antibody. The patient was then diagnosed with anti-NMDAR encephalitis during the remission of optic neuritis. Hormone treatment effectively relieved the symptoms, without recurrence at 1 year of follow-up. Conclusion Epilepsy symptoms in patients with optic neuritis alert testing for antibodies associated with autoimmune encephalitis. An early diagnosis favors the treatment.

Key words: anti-N-methyl-D-aspartate receptor encephalitis, optic neuritis, negative AQP4 antibody, negative MOG antibody

CLC Number:

R739.4
R745

Kong Fancong, Wang Fangyu, Fan Kai, Liu Gengxi, Zhao Lianjiang, Liu Fei. Anti-NMDAR encephalitis during the remission of optic neuritis: A case report and literature review[J]. Clinical Focus, 2025, 40(5): 450-453.

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URL: http://www.lchc.cn/EN/10.3969/j.issn.1004-583X.2025.05.012

http://www.lchc.cn/EN/Y2025/V40/I5/450

Figures/Tables 2

References 19

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项目	脑脊液结果	血清结果	参考区间
抗NMDAR1抗体IgG	强阳性(+++)	弱阳性(+)	阴性(-)
抗AMPA1抗体IgG	阴性(-)	阴性(-)	阴性(-)
抗AMPA2抗体IgG	阴性(-)	阴性(-)	阴性(-)
抗LGI1抗体IgG	阴性(-)	阴性(-)	阴性(-)
抗GABABR1抗体IgG	阴性(-)	阴性(-)	阴性(-)
抗CASPR2抗体IgG	阴性(-)	阴性(-)	阴性(-)
抗DPPX(全)抗体IgG	阴性(-)	阴性(-)	阴性(-)
抗DPPX(外膜)抗体IgG	阴性(-)	阴性(-)	阴性(-)
抗IgLON5抗体IgG	阴性(-)	阴性(-)	阴性(-)
抗AQP4抗体IgG	阴性(-)	阴性(-)	阴性(-)
抗MOG抗体IgG	阴性(-)	阴性(-)	阴性(-)
抗GQ1b抗体IgG	阴性(-)	阴性(-)	阴性(-)
抗GQ1b抗体IgM	阴性(-)	阴性(-)	阴性(-)

项目	脑脊液结果	血清结果	参考区间
抗NMDAR1抗体IgG	强阳性(+++)	弱阳性(+)	阴性(-)
抗AMPA1抗体IgG	阴性(-)	阴性(-)	阴性(-)
抗AMPA2抗体IgG	阴性(-)	阴性(-)	阴性(-)
抗LGI1抗体IgG	阴性(-)	阴性(-)	阴性(-)
抗GABABR1抗体IgG	阴性(-)	阴性(-)	阴性(-)
抗CASPR2抗体IgG	阴性(-)	阴性(-)	阴性(-)
抗DPPX(全)抗体IgG	阴性(-)	阴性(-)	阴性(-)
抗DPPX(外膜)抗体IgG	阴性(-)	阴性(-)	阴性(-)
抗IgLON5抗体IgG	阴性(-)	阴性(-)	阴性(-)
抗AQP4抗体IgG	阴性(-)	阴性(-)	阴性(-)
抗MOG抗体IgG	阴性(-)	阴性(-)	阴性(-)
抗GQ1b抗体IgG	阴性(-)	阴性(-)	阴性(-)
抗GQ1b抗体IgM	阴性(-)	阴性(-)	阴性(-)