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- Hiroyuki Sumikura, Mai Ito, Takuma Sato, Naoki Hatayama, Tomohiro Fujioka, Nozomi Nagashima, Yuki Shimada, Isao Fukasaka, Mikito Shimizu, Kyoko Higashida, Taku Hoshi, Keiko Tanaka, and Manabu Sakaguchi.
- Department of Neurology, Osaka General Medical Center, Japan.
- Intern. Med. 2024 Dec 1; 63 (23): 323732413237-3241.
AbstractA 44-year-old woman with a subacute onset of an altered mental status, urinary retention, and fluctuating blood pressure was initially diagnosed with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis, meeting the criteria of Graus et al. Cardiac arrest occurred, which required pacemaker placement. She subsequently showed profound flaccid limb paralysis, with magnetic resonance imaging demonstrating focal necrotic lesions localized in the anterior horn of the longitudinal segments of the spinal cord and in the pontine tegmentum. Enteroviruses or autoimmune encephalitis-associated autoantibodies were not detected. We herein report a case of acute flaccid myelitis with profound psychiatric symptoms and dysautonomia, resembling NMDAR encephalitis.
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