Abstract
Here we described an 18-year-old woman who were initially misdiagnosed as psychiatric disorders in a psychiatric institution. She was transferred to our neurological ward because of impaired consciousness. Neuronal antibody testing confirmed the diagnosis of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. Cerebral magnetic resonance imaging (MRI) revealed a concomitant disorder named reversible splenial lesion syndrome (RESLES). After administration of combined immunotherapy, the patient recovered completely 3 months after discharge. To our knowledge, co-occurrence of RESLES and anti-NMDAR encephalitis was only described in two patients with teratoma and we provide another case without teratoma. We highlight that anti-NMDAR antibodies can be added to the multiple causes of RESLES. It is therefore imperative for clinicians to detect anti-neuronal antibodies in patients with RESLES to avoid missed diagnosis.
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The authors included all data generated or analyzed during this study in this published article.
Abbreviations
- NMDAR:
-
Anti-N-methyl-D-aspartate receptor
- CSF:
-
Cerebrospinal fuid
- NSE:
-
Neuron specific enolase
- EEG:
-
Electroencephalogram
- MRI:
-
Magnetic resonance imaging
- FLAIR:
-
Fluid-attenuated inversion recovery
- DWI:
-
Diffusion-weighted imaging
- ADC:
-
Apparent diffusion coefficient
- IVIG:
-
Introvenous immunoglobulin
- VGKC:
-
Voltage-gated potassium channel
- GFAP:
-
Glial fibrillary acidic protein
References
Tetsuka S (2019) Reversible lesion in the splenium of the corpus callosum. Brain Behav 9(11):e01440
Li Y, Zhang M, Liu D et al (2023) Case report: Autoimmune encephalitis with multiple auto-antibodies with reversible splenial lesion syndrome and bilateral ovarian teratoma. Front Immunol 12(13):1029294
Zhang Y, Lian B, Yang S et al (2023) Metabotropic glutamate receptor 5-related autoimmune encephalitis with reversible splenial lesion syndrome following SARS-CoV-2 vaccination. Medicine (Baltimore) 102(7):e32971
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All authors contributed to the study's conception and design. **aohua Mu studied the case and collected the data. Rong Wei drafted and reviewed the manuscript. Li Zhou revised the manuscript. All authors commented on previous versions of the manuscript. The manuscript complies with all instructions to authors, authorship requirements have been met, and all authors approved the fnal manuscript.
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The authors have no relevant financial or non-financial interests to disclose.The authors have no competing interests to declare that are relevant to the content of this article.
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Written informed consent for publication of her clinical details and clinical images was obtained from the patient.This study was granted exemption from requiring additional ethics approval as per local protocol.
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Wei, R., Mu, X. & Zhou, L. Reversible splenial lesion syndrome in Anti-N-methyl-D-aspartate receptor encephalitis. Neurol Sci (2024). https://doi.org/10.1007/s10072-024-07646-x
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DOI: https://doi.org/10.1007/s10072-024-07646-x