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Magnetic resonance imaging and magnetic resonance spectroscopy in a young male patient with anti-N-methyl-D-aspartate receptor encephalitis and uncommon cerebellar involvement: A case report with review of the literature.
Neuroradiol J. 2016 Feb; 29(1):30-5.NJ

Abstract

We report a case of a 17-year-old man presenting with new onset psychiatric symptoms. Magnetic resonance imaging (MRI) and proton magnetic resonance (MR) spectroscopy revealed some lesions in the right cerebellar hemisphere and ipsilateral cerebellar tonsil suggestive of encephalitis. An extensive workup was negative for both infectious and neoplastic diseases and he was afterward diagnosed with anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis. This disorder is an autoimmune encephalitis, highly lethal but curable, predominantly found in young female with ovarian teratoma. He received methylprednisolone. His clinical findings gradually improve and he made a complete recovery. Accordingly, repeated brain MRI and proton MR spectroscopy showed a gradual reduction of the lesions; MRI taken six months after starting therapy showed complete resolution of the lesions. Our case shows that, although rare, anti-NMDAR encephalitis should be considered also in young men for whom a rapid onset of psychiatric neurological disorders cannot be explained by more frequent causes. Our report underlines also the usefulness of MRI and proton MR spectroscopic findings in the diagnosis and follow-up of this disease.

Authors+Show Affiliations

Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy alessandra.splendiani@cc.univaq.it.Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy.Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy.Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy.Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy.Department of Mental Health, S. Salvatore Hospital, 67100, L'Aquila, Italy.Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy.Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy.Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy.

Pub Type(s)

Case Reports
Journal Article
Review

Language

eng

PubMed ID

26613928

Citation

Splendiani, Alessandra, et al. "Magnetic Resonance Imaging and Magnetic Resonance Spectroscopy in a Young Male Patient With anti-N-methyl-D-aspartate Receptor Encephalitis and Uncommon Cerebellar Involvement: a Case Report With Review of the Literature." The Neuroradiology Journal, vol. 29, no. 1, 2016, pp. 30-5.
Splendiani A, Felli V, Di Sibio A, et al. Magnetic resonance imaging and magnetic resonance spectroscopy in a young male patient with anti-N-methyl-D-aspartate receptor encephalitis and uncommon cerebellar involvement: A case report with review of the literature. Neuroradiol J. 2016;29(1):30-5.
Splendiani, A., Felli, V., Di Sibio, A., Gennarelli, A., Patriarca, L., Stratta, P., Di Cesare, E., Rossi, A., & Massimo, G. (2016). Magnetic resonance imaging and magnetic resonance spectroscopy in a young male patient with anti-N-methyl-D-aspartate receptor encephalitis and uncommon cerebellar involvement: A case report with review of the literature. The Neuroradiology Journal, 29(1), 30-5. https://doi.org/10.1177/1971400915609333
Splendiani A, et al. Magnetic Resonance Imaging and Magnetic Resonance Spectroscopy in a Young Male Patient With anti-N-methyl-D-aspartate Receptor Encephalitis and Uncommon Cerebellar Involvement: a Case Report With Review of the Literature. Neuroradiol J. 2016;29(1):30-5. PubMed PMID: 26613928.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Magnetic resonance imaging and magnetic resonance spectroscopy in a young male patient with anti-N-methyl-D-aspartate receptor encephalitis and uncommon cerebellar involvement: A case report with review of the literature. AU - Splendiani,Alessandra, AU - Felli,Valentina, AU - Di Sibio,Alessandra, AU - Gennarelli,Antonio, AU - Patriarca,Lucia, AU - Stratta,Paolo, AU - Di Cesare,Ernesto, AU - Rossi,Alessandro, AU - Massimo,Gallucci, Y1 - 2015/11/27/ PY - 2015/11/29/entrez PY - 2015/11/29/pubmed PY - 2016/6/9/medline KW - Magnetic Resonance Imaging KW - Magnetic Resonance spectroscopy KW - anti-NMDAR encephalitis SP - 30 EP - 5 JF - The neuroradiology journal JO - Neuroradiol J VL - 29 IS - 1 N2 - We report a case of a 17-year-old man presenting with new onset psychiatric symptoms. Magnetic resonance imaging (MRI) and proton magnetic resonance (MR) spectroscopy revealed some lesions in the right cerebellar hemisphere and ipsilateral cerebellar tonsil suggestive of encephalitis. An extensive workup was negative for both infectious and neoplastic diseases and he was afterward diagnosed with anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis. This disorder is an autoimmune encephalitis, highly lethal but curable, predominantly found in young female with ovarian teratoma. He received methylprednisolone. His clinical findings gradually improve and he made a complete recovery. Accordingly, repeated brain MRI and proton MR spectroscopy showed a gradual reduction of the lesions; MRI taken six months after starting therapy showed complete resolution of the lesions. Our case shows that, although rare, anti-NMDAR encephalitis should be considered also in young men for whom a rapid onset of psychiatric neurological disorders cannot be explained by more frequent causes. Our report underlines also the usefulness of MRI and proton MR spectroscopic findings in the diagnosis and follow-up of this disease. SN - 1971-4009 UR - https://www.unboundmedicine.com/medline/citation/26613928/Magnetic_resonance_imaging_and_magnetic_resonance_spectroscopy_in_a_young_male_patient_with_anti_N_methyl_D_aspartate_receptor_encephalitis_and_uncommon_cerebellar_involvement:_A_case_report_with_review_of_the_literature_ L2 - https://journals.sagepub.com/doi/10.1177/1971400915609333?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -