Anti-NMDA receptor encephalitis presenting as isolated aphasia in an adult

ABSTRACT

Anti-NMDA receptor (NMDA-r) encephalitis is a relatively rare cause of autoimmune encephalitis with divergent clinical presentations. We report a case of an adult patient with anti-NMDA-r encephalitis presenting with isolated, abrupt-onset aphasia. Her condition remained unaltered over a period of 6 months. The patients’ electroencephalogram findings were typical for NMDA-r encephalitis; however, her magnetic resonance imaging and cerebrospinal fluid analysis were normal. She responded well to immunotherapy, and aphasia eventually resolved. The natural course of the present case contradicts the rapidly progressive nature of typical NMDA-r encephalitis. Furthermore, it broadens the clinical spectrum of anti-NMDA-r encephalitis, to incorporate isolated, nonprogressive aphasia.

KEYWORDS:

• Anti-NMDA-r encephalitis
• aphasia
• immunotherapy
• language
• cognitive decline

Acknowledgments

The authors would like to thank Lina Chatziantoniou for the patient’s third neuropsychological assessment. DK is supported by IKY Scholarships Programme cofinanced by the European Union (European Social Fund [ESF]) and Greek national funds through the action entitled “Reinforcement of Postdoctoral Researchers,” in the framework of the Operational Programme “Human Resources Development Program, Education and Lifelong Learning” of the National Strategic Reference Framework (NSRF) 2014–2020.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

DK is supported by IKY Scholarships Programme cofinanced by the European Union (European Social Fund [ESF]) and Greek national funds through the action entitled “Reinforcement of Postdoctoral Researchers,” in the framework of the Operational Programme “Human Resources Development Program, Education and Lifelong Learning” of the National Strategic Reference Framework (NSRF) 2014–2020.