Gerstmann's Syndrome in a Patient Double-positive for Antibodies Against the N-methyl-D-aspartate Receptor and NH-terminal of α-enolase

Overview

Journal Intern Med

Specialty General Medicine

Date 2020 Nov 24

PMID 33229813

Authors

Atsuhiko Sugiyama

Masahide Suzuki

Tomoki Suichi

Tomohiko Uchida

Takahiro Iizuka

Keiko Tanaka

Makoto Yoneda

Satoshi Kuwabara

Affiliations

Soon will be listed here.

Abstract

We herein report a case of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis concurrent with NH-terminal of α-enolase (NAE) antibodies. A 36-year-old Japanese woman presented with Gerstmann's syndrome followed by jerky involuntary movements, seizure, autonomic instability, and consciousness disturbance. NAE antibodies were detected in the serum; however, NMDAR antibodies were identified in the cerebrospinal fluid with a cell-based assay, confirming the diagnosis of anti-NMDAR encephalitis. This case highlights the fact that Gerstmann's syndrome can be a manifestation of anti-NMDAR encephalitis and that NAE may be identified concurrently with NMDAR antibodies, suggesting that the diagnosis of Hashimoto encephalopathy requires the reasonable exclusion of alternative diagnoses, including anti-NMDAR encephalitis.

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