Dement Neurocogn Disord.  2015 Dec;14(4):176-179. 10.12779/dnd.2015.14.4.176.

Anti-N-Methyl-D-Aspartate Receptor Encephalitis Presenting Progressive Dyslexia: A Case Report

• Pan KH
• Kim JH
• Kim BJ
• Lee CN

• KMID: 2442937
• DOI: http://doi.org/10.12779/dnd.2015.14.4.176

Abstract

BACKGROUND
Anti-N-methyl-D-aspartate (anti-NMDA) receptor encephalitis was discovered less than 10 years ago. Its symptoms and characteristics are not well-defined yet. We experienced a case of anti-NMDA receptor encephalitis with phonemic paraphasia and acalculia that were not classical characteristics.
CASE REPORT
A 44-year-old woman started to show dyslexia, phonemic paraphasia, and dyscalculia. These symptoms were gradually worsening for over 30 days. Various brain images were not helpful for primary diagnosis. Anti-NMDA receptor encephalitis was confirmed in two different laboratories. The patient started to recover with various immunosuppressive therapies.
CONCLUSIONS
Anti-NMDA receptor encephalitis can have various symptoms, including phonemic paraphasia and acalculia.

Keyword

anti-N-methyl-D-aspartate receptor encephalitis; dyslexia; acaculia; paraphasia

MeSH Terms

Adult
Anti-N-Methyl-D-Aspartate Receptor Encephalitis*
Brain
Diagnosis
Dyscalculia
Dyslexia*
Encephalitis
Female
Humans

Figure

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  Fig. 1 MRI FLAIR image showing slightly high signal intensity on the left hippocampus (head to tail). FLAIR: fluid-attenuated inversion recovery, MRI: magnetic resonance image.

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  Fig. 2 Brain SPECT (Tc-99m) showing relatively hyper-metabolic state on the left temporal cortical area than the right hemisphere. Right cerebellar area also shows hyper-metabolic state. SPECT: single-photon emission computed tomography.

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  Fig. 3 A: Electroencephalogram (EEG) showing continuous 1–1.5 Hz delta slow activity on the left hemisphere with delta brush like findings. B: Delta brush pattern in EEG. Delta rhythms superimposed with brush like small amplitude fast activity.

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