Neurológia pre prax 2/2018
Anti-NMDAr-panecefalitida – klinická kazuistika
Anti-N-methyl-D-aspartate receptor panencephalitis – case report Encephalitis with antibodies to N-methyl-D-aspartate receptors (NMDAR) is currently the second most common autoimmune encephalitis in adolescents and young adults (after ADEM – acute disseminated encephalomyelitis). Due to the rapid development of laboratory diagnostics and the discovery of the nature of this disease, namely antibodies to N-methyl-D-aspartate receptors, the diagnosis has been taken out of a subset of autoimmune encephalitis and has become a separate, independent unit (Dalmau et al., 2007). Because of the above, the exact incidence and prevalence of the disease is not yet known and an underdiagnosis of the patients is anticipated. Anti- NMDAR encephalitis is a disease with subacute onset, manifested by a complex of progressing neurological-psychiatric problems. It requires intensive and prolonged immunosuppressive therapy, not rarely with the support and monitoring of vital functions in intensive care units. Disease prognosis, however, is favorable, and the "outcome" is based on early diagnosis and subsequently properly chosen therapy. This paper offers a brief summary of information about anti-NMDAR encephalitis. It mainly focuses on clinical manifestation and progression, diagnosis, including the results of secondary paraclinical examinations, immunosuppressive therapy management, and prognosis of the disease. In the conclusion, we present a case report of our patient with a typical course of autoimmune encephalitis with antibodies against NMDAR.
Keywords: N-methyl-D-aspartate receptor, autoimmune encephalitis, oligoclonal bands, catatonia
