Repeated anti-N-methyl-D-aspartate receptor encephalitis coexisting with anti-myelin oligodendrocyte glycoprotein antibody-associated diseases: A case report

•Anti-NMDAR encephalitis coexisted with anti-MOG antibody (MOG-Ab)-associated disease.•This case showed symptoms due to MOG-Ab followed by anti-NMDAR encephalitis.•The symptoms due to MOG-Ab were balance disability and word-finding difficulty.•MOG-Ab testing should be performed in anti-NMDAR encepha...

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Bibliographic Details
Published in:Multiple sclerosis and related disorders 2019-10, Vol.35, p.182-184
Main Authors: Aoe, Shingo, Kokudo, Yohei, Takata, Tadayuki, Kobara, Hideki, Yamamoto, Mitsutoshi, Touge, Tetsuo, Deguchi, Kazushi, Masaki, Tsutomu
Format: Article
Language:English
Subjects:
Adult
Anti-MOG antibody
Anti-N-Methyl-D-Aspartate Receptor Encephalitis - complications
Anti-N-Methyl-D-Aspartate Receptor Encephalitis - diagnostic imaging
Anti-N-Methyl-D-Aspartate Receptor Encephalitis - immunology
Ataxia
Autoantibodies - immunology
Autoimmune Diseases - complications
Autoimmune Diseases - diagnostic imaging
Autoimmune Diseases - immunology
Brain - diagnostic imaging
Female
Humans
Magnetic Resonance Imaging
Myelin oligodendrocyte glycoprotein (MOG)
Myelin-Oligodendrocyte Glycoprotein - immunology
N-methyl-D-aspartate receptor
Word-finding difficulty
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Summary:•Anti-NMDAR encephalitis coexisted with anti-MOG antibody (MOG-Ab)-associated disease.•This case showed symptoms due to MOG-Ab followed by anti-NMDAR encephalitis.•The symptoms due to MOG-Ab were balance disability and word-finding difficulty.•MOG-Ab testing should be performed in anti-NMDAR encephalitis with atypical symptoms. The coexistence of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis and anti-myelin oligodendrocyte glycoprotein antibody (MOG-Ab)-associated diseases has been reported. We report the case of a 36-year-old woman who presented with repeated typical anti-NMDAR encephalitis coexisting with unusual symptoms not consistent with anti-NMDAR encephalitis. Apart from the anti-NMDAR encephalitis, her first episode was characterized by balance disability with bilateral medial frontal cortical lesions, suggesting the involvement of the cortico-reticular projections and the basal ganglia-brainstem projections. The second episode presented with Broca's aphasia caused by involvement of the Broca's area and lower part of the precentral gyrus. The detection of MOG-Ab in both episodes suggested the coexistence of MOG-Ab-associated diseases. Thus, an evaluation of MOG-Ab should be considered when anti-NMDAR encephalitis presenting with atypical symptoms is encountered.
ISSN:2211-0348
2211-0356
DOI:10.1016/j.msard.2019.08.002