Teaching NeuroImages: NMDA encephalomyelitis with MRI abnormalities isolated to ventral spinal cord gray matter
A 17-year-old girl presented with a month of anxiety followed by acute psychosis, catatonia, choreoathetosis, seizures, autonomic instability, lower extremity spasticity, and hyperreflexia. CSF was positive for the NMDA antibody; additional antibodies and infectious etiologies tested negative. MRI b...
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| Veröffentlicht in: | Neurology 2015-08, Vol.85 (6), p.e55-e56 |
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| creator | Zubkov, Sarah Aggarwal Joshi, Puja Shepherd, Timothy M Kothare, Sanjeev V |
| description | A 17-year-old girl presented with a month of anxiety followed by acute psychosis, catatonia, choreoathetosis, seizures, autonomic instability, lower extremity spasticity, and hyperreflexia. CSF was positive for the NMDA antibody; additional antibodies and infectious etiologies tested negative. MRI brain was normal. MRI spine revealed symmetric T2 hyperintensities in ventral gray matter (figure). EEG showed extreme delta brush. She received the following sequentially: IV gammaglobulin, methylprednisolone, ovarian teratoma resection, and plasmapheresis, only improving after rituximab. At 3 months, repeat MRI spine and motor examination results were normal. NMDA encephalitis with myelopathy is rare[1,2]; spinal cord gray matter involvement has not been reported previously. |
| doi_str_mv | 10.1212/WNL.0000000000001839 |
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CSF was positive for the NMDA antibody; additional antibodies and infectious etiologies tested negative. MRI brain was normal. MRI spine revealed symmetric T2 hyperintensities in ventral gray matter (figure). EEG showed extreme delta brush. She received the following sequentially: IV gammaglobulin, methylprednisolone, ovarian teratoma resection, and plasmapheresis, only improving after rituximab. At 3 months, repeat MRI spine and motor examination results were normal. NMDA encephalitis with myelopathy is rare[1,2]; spinal cord gray matter involvement has not been reported previously.</description><identifier>ISSN: 0028-3878</identifier><identifier>EISSN: 1526-632X</identifier><identifier>DOI: 10.1212/WNL.0000000000001839</identifier><identifier>PMID: 26259859</identifier><language>eng</language><publisher>United States: American Academy of Neurology</publisher><subject>Adolescent ; Anti-N-Methyl-D-Aspartate Receptor Encephalitis - diagnosis ; Anti-N-Methyl-D-Aspartate Receptor Encephalitis - physiopathology ; Female ; Gray Matter - pathology ; Humans ; Magnetic Resonance Imaging ; Resident and Fellow Section ; Spinal Cord - pathology</subject><ispartof>Neurology, 2015-08, Vol.85 (6), p.e55-e56</ispartof><rights>2015 American Academy of Neurology</rights><rights>2015 American Academy of Neurology 2015 American Academy of Neurology</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26259859$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zubkov, Sarah</creatorcontrib><creatorcontrib>Aggarwal Joshi, Puja</creatorcontrib><creatorcontrib>Shepherd, Timothy M</creatorcontrib><creatorcontrib>Kothare, Sanjeev V</creatorcontrib><title>Teaching NeuroImages: NMDA encephalomyelitis with MRI abnormalities isolated to ventral spinal cord gray matter</title><title>Neurology</title><addtitle>Neurology</addtitle><description>A 17-year-old girl presented with a month of anxiety followed by acute psychosis, catatonia, choreoathetosis, seizures, autonomic instability, lower extremity spasticity, and hyperreflexia. CSF was positive for the NMDA antibody; additional antibodies and infectious etiologies tested negative. MRI brain was normal. MRI spine revealed symmetric T2 hyperintensities in ventral gray matter (figure). EEG showed extreme delta brush. She received the following sequentially: IV gammaglobulin, methylprednisolone, ovarian teratoma resection, and plasmapheresis, only improving after rituximab. At 3 months, repeat MRI spine and motor examination results were normal. NMDA encephalitis with myelopathy is rare[1,2]; spinal cord gray matter involvement has not been reported previously.</description><subject>Adolescent</subject><subject>Anti-N-Methyl-D-Aspartate Receptor Encephalitis - diagnosis</subject><subject>Anti-N-Methyl-D-Aspartate Receptor Encephalitis - physiopathology</subject><subject>Female</subject><subject>Gray Matter - pathology</subject><subject>Humans</subject><subject>Magnetic Resonance Imaging</subject><subject>Resident and Fellow Section</subject><subject>Spinal Cord - pathology</subject><issn>0028-3878</issn><issn>1526-632X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkd2L1DAUxYMo7rj6H4jk0Zeu-Wia1AdhWb8GZkeQFX0LaXo7jaZNN0l3mP_eDrPK-uZ9OXDvj8PhHoReUnJBGWVvvm83F-TBUMXrR2hFBauKirMfj9GKEKYKrqQ6Q89S-rkwgsn6KTpjFRO1EvUKhRswtnfjDm9hjmE9mB2kt3h7_f4Sw2hh6o0PwwG8yy7hvcs9vv66xqYZQxzMcQsJuxS8ydDiHPAdjDkaj9PkxkVsiC3eRXPAg8kZ4nP0pDM-wYt7PUffPn64ufpcbL58Wl9dboqJyVIWllgqmaSms8q2pil5A0KoireEd8CVaVhXK9W2wCzjomWiqRRvOttUHQjD-Dl6d_Kd5maA1p5S6Sm6wcSDDsbpfy-j6_Uu3OlSlISVajF4fW8Qw-0MKevBJQvemxHCnDSVlahrRiT9D5RwSWWpxIK-ehjrb54_hSxAeQL2wS_vSr_8vIeoezA-9_rYc0VpWbClSqIoJcWxecl_A58IoMI</recordid><startdate>20150811</startdate><enddate>20150811</enddate><creator>Zubkov, Sarah</creator><creator>Aggarwal Joshi, Puja</creator><creator>Shepherd, Timothy M</creator><creator>Kothare, Sanjeev V</creator><general>American Academy of Neurology</general><general>Lippincott Williams & Wilkins</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope><scope>7TK</scope><scope>5PM</scope></search><sort><creationdate>20150811</creationdate><title>Teaching NeuroImages: NMDA encephalomyelitis with MRI abnormalities isolated to ventral spinal cord gray matter</title><author>Zubkov, Sarah ; Aggarwal Joshi, Puja ; Shepherd, Timothy M ; Kothare, Sanjeev V</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p2747-c0c17271afc8cdab43be55863d03fe38ab2f988dde2c235d25b683bfcb6fe5a23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adolescent</topic><topic>Anti-N-Methyl-D-Aspartate Receptor Encephalitis - diagnosis</topic><topic>Anti-N-Methyl-D-Aspartate Receptor Encephalitis - physiopathology</topic><topic>Female</topic><topic>Gray Matter - pathology</topic><topic>Humans</topic><topic>Magnetic Resonance Imaging</topic><topic>Resident and Fellow Section</topic><topic>Spinal Cord - pathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zubkov, Sarah</creatorcontrib><creatorcontrib>Aggarwal Joshi, Puja</creatorcontrib><creatorcontrib>Shepherd, Timothy M</creatorcontrib><creatorcontrib>Kothare, Sanjeev V</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><collection>Neurosciences Abstracts</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zubkov, Sarah</au><au>Aggarwal Joshi, Puja</au><au>Shepherd, Timothy M</au><au>Kothare, Sanjeev V</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Teaching NeuroImages: NMDA encephalomyelitis with MRI abnormalities isolated to ventral spinal cord gray matter</atitle><jtitle>Neurology</jtitle><addtitle>Neurology</addtitle><date>2015-08-11</date><risdate>2015</risdate><volume>85</volume><issue>6</issue><spage>e55</spage><epage>e56</epage><pages>e55-e56</pages><issn>0028-3878</issn><eissn>1526-632X</eissn><abstract>A 17-year-old girl presented with a month of anxiety followed by acute psychosis, catatonia, choreoathetosis, seizures, autonomic instability, lower extremity spasticity, and hyperreflexia. 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| language | eng |
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| source | MEDLINE; Journals@Ovid Complete; Alma/SFX Local Collection |
| subjects | Adolescent Anti-N-Methyl-D-Aspartate Receptor Encephalitis - diagnosis Anti-N-Methyl-D-Aspartate Receptor Encephalitis - physiopathology Female Gray Matter - pathology Humans Magnetic Resonance Imaging Resident and Fellow Section Spinal Cord - pathology |
| title | Teaching NeuroImages: NMDA encephalomyelitis with MRI abnormalities isolated to ventral spinal cord gray matter |
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