Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Front Immunol. 2024 May 10;15:1388667. doi: 10.3389/fimmu.2024.1388667. eCollection 2024.
Cerebellar ataxia is an uncommon and atypical manifestation of anti--methyl-D-aspartate receptor (NMDAR) encephalitis, often accompanied by seizures, psychiatric symptoms, and cognitive deficits. Previous cases of isolated brainstem-cerebellar symptoms in patients with anti-NMDAR encephalitis have not been documented. This report presents a case of anti-NMDAR encephalitis in which the patient exhibited cerebellar ataxia, nystagmus, diplopia, positive bilateral pathological signs, and hemiparesthesia with no other accompanying symptoms or signs. The presence of positive CSF anti-NMDAR antibodies further supports the diagnosis. Other autoantibodies were excluded through the use of cell-based assays. Immunotherapy was subsequently administered, leading to a gradual recovery of the patient.
小脑性共济失调是抗 N-甲基-D-天冬氨酸受体(NMDAR)脑炎的一种不常见且非典型表现,常伴有癫痫发作、精神症状和认知缺陷。以前没有记录到抗 NMDAR 脑炎患者孤立的脑干-小脑症状的病例。本报告介绍了一例抗 NMDAR 脑炎患者,该患者表现为小脑共济失调、眼球震颤、复视、双侧病理征阳性和半身感觉障碍,无其他伴随症状或体征。脑脊液抗 NMDAR 抗体阳性进一步支持诊断。通过使用基于细胞的检测排除了其他自身抗体。随后进行了免疫治疗,患者逐渐康复。