Overlapping anti-N-methyl-D-aspartate receptor encephalitis and anti-myelin oligodendrocyte glycoprotein cerebral cortical encephalitis

Abstract

  A 12-year-old previously healthy boy was admitted for psycho-behavioral symptoms. He was diagnosed with anti-N-methyl-D-aspartate (NMDA) receptor encephalitis by antibody test and improved by immunotherapy. However, he was re-admitted for seizures, speech and writing difficulties with abnormal MRI findings in the left frontal cortex. His cerebrospinal fluid samples were positive for anti-myelin oligodendrocyte glycoprotein (MOG) and anti-NMDA receptor antibodies in both episodes. The coexistence of both antibodies induced different symptoms between the two episodes, and anti-NMDA receptor encephalitis is associated with anti-MOG antibody and cerebral cortical encephalitis.