Pediatric Anti-N-methyl-D-aspartate Receptor Encephalitis Mimicking Glutaric Aciduria Type 1: A Case Report

Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an immune-mediated disease that induces a wide spectrum of symptoms, especially in toddlers. These include acute-onset movement disorders, with neurological regression, and other associated neurological symptoms. Anti-NMDAR encephalitis rema...

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Bibliographic Details
Published inFrontiers in neurology Vol. 11
Main Authors Valle, Daniel Almeida do, Santos, Mara Lúcia Schmitz Ferreira, Zeny, Michelle Silva, Cordeiro, Mara L.
Format Journal Article
LanguageEnglish
Published Frontiers Media S.A 26.10.2020
Subjects
anti-N-methyl-D-aspartate receptor encephalitis
antibody
child
dystonia
glutaric acidemia I
Neurology
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Summary:Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an immune-mediated disease that induces a wide spectrum of symptoms, especially in toddlers. These include acute-onset movement disorders, with neurological regression, and other associated neurological symptoms. Anti-NMDAR encephalitis remains a diagnostic challenge, especially in toddlers, with better prognosis associated with early treatment. We report the case of a 15-months-old boy who initially presented with vomiting and later with acute-onset dystonia after the administration of antiemetics. Within 14 days, the patient developed neuropsychomotor developmental regression and worsening dystonia. After ruling out an acute dystonic reaction and glutaric acidemia type 1 (GA-1), a final diagnosis of anti-NMDAR encephalitis was made. The patient responded well to immunomodulatory therapy. The present case underscores the importance of early treatment for patient prognosis and of including anti-NMDAR encephalitis in the differential diagnosis of acute-onset movement disorders.
Bibliography:This article was submitted to Multiple Sclerosis and Neuroimmunology, a section of the journal Frontiers in Neurology
Edited by: Long-Jun Wu, Mayo Clinic, United States
Reviewed by: Qian Wu, Capital Medical University, China; Cristina Valencia-Sanchez, Mayo Clinic, United States
ISSN:1664-2295
1664-2295
DOI:10.3389/fneur.2020.587324