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Arch Neurol. 2010 Jan;67(1):118-21. doi: 10.1001/archneurol.2009.299.

Opsoclonus-myoclonus syndrome in anti-N-methyl-D-aspartate receptor encephalitis.

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  • 1Department of Neurosciences, Faculty of Medicine, University of Geneva, Geneva, Switzerland.

Abstract

BACKGROUND:

Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis has been recently reported as autoimmune/paraneoplastic encephalitis, affecting mostly young females.

OBJECTIVE:

To describe opsoclonus-myoclonus syndrome in association with anti-NMDAR antibodies.

DESIGN:

Case report.

SETTING:

Geneva University Hospital. Patient A 23-year-old woman with opsoclonus-myoclonus syndrome.

RESULTS:

Two weeks after an episode of gastroenteritis, the patient developed symptoms of depression associated with psychomotor slowing, progressive gait instability, and opsoclonus-myoclonus. Cerebrospinal fluid examination showed mild lymphocytic pleocytosis and intrathecal IgG synthesis with oligoclonal bands. The patient's condition worsened rapidly to an akinetic mutism, followed by a period of agitation, delirium, and hallucinations. These gradually subsided; however, a frontal behavior and executive dysfunction persisted 5 months after symptom presentation. No tumor was found. Anti-NMDAR antibodies were found in the cerebrospinal fluid.

CONCLUSIONS:

Opsoclonus-myoclonus may occur in patients with anti-NMDAR encephalitis. Prompt diagnosis of this disorder is important because after tumor removal and immunomodulatory therapies it has a relatively good prognosis.

PMID:
20065141
[PubMed - indexed for MEDLINE]
PMCID:
PMC2819405
Free PMC Article
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