Abstract :
Anti-N-methyl D-aspartate receptor (anti- NMDAR) encephalitis, recently recognized as a form of paraneoplastic encephalitis, is characterized by a prodromal phase of unspecific illness with fever that resembles a viral disease. The prodromal phase is followed by seizures, disturbed consciousness, psychiatric features, prominent abnormal movements, and autonomic imbalance. Here, we report a case of anti-NMDAR encephalitis with initial symptoms of epilepsia partialis continua in the absence of tumor. A 6- years-old girl was admitted to the hospital with complaint of right-sided, complex partial seizures without fever. The seizures evolved into epilepsia partialis continua and were accompanied by epileptiform discharges from the bilateral hemispheres. Three weeks after admission, the patient’s seizures were reduced with antiepileptic drugs; however, she developed sleep disturbances, behaivoural abnormalities, cognitive decline, insomnia and mutism. Anti-NMDAR encephalitis was confirmed by clinical findings of the child and her condition slowly improved with methylprednisolone. Moreover, the patient showed gradual improvement of behavioural and cognitive function. This case serves as an example that a diagnosis of anti-NMDAR encephalitis should be considered even with low titres of Anti NMDAR antibodies being positive but with uncontrolled seizures, insomnias and mutism without evidence of malignant tumour.
Keyword :
Anti-N-methyl-D-aspartate receptor encephalitis, Epilepsia partialis continua, Child