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060 Fulminant meningitis as a presenting feature of anti ...

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Anti-NMDA receptor encephalitis is a well-recognised immunotherapy-responsive condition which often occurs as a paraneoplastic phenomenon. Skiptomaincontent YouarehereHome Archive Volume90, Issue12 060 Fulminantmeningitisasapresentingfeatureofanti-NMDAreceptorencephalitis Emailalerts ArticleText Articlemenu ArticleText Articleinfo CitationTools Share RapidResponses Articlemetrics Alerts PDF Parallelsession6:ClinicalNeurology2 060 Fulminantmeningitisasapresentingfeatureofanti-NMDAreceptorencephalitis MariaStavrou1,2,JingMingYeo1,AlexanderDavidSlater3,SaroshIrani4,PeterFoley1 1DepartmentofClinicalNeurosciences,WesternGeneralHospital,Edinburgh 2CentreofClinicalBrainSciences,UniversityofEdinburgh 3MedicalEducationCentre,MonklandsHospital 4NuffieldDepartmentofClinicalNeurosciences,UniversityofOxford,Oxford AbstractAnti-NMDAreceptorencephalitisisawell-recognisedimmunotherapy-responsiveconditionwhichoftenoccursasaparaneoplasticphenomenon.Atypicalpresentationisinayoungindividualwithaviral-likeprodromefollowedbythedevelopmentofseverepsychiatricsymptoms,memoryloss,seizures,reducedconsciousnessandsometimesorofacialdyskinesias,andprogressiontoautonomicandrespiratoryinstability.Fulminantmeningitisisaveryrarepresentingfeatureofanti-NMDAreceptorencephalitiswithourliteraturesearchonlyrevealingoneotherreportedcase.Wepresentacaseofa33-yearoldCaucasianwomanwhoinitiallypresentedwithlymphocyticmeningitisbutsubsequentlydevelopedclinicalandinvestigativefeaturesconsistentwithanti-NMDAreceptorencephalitis.Throughthiscase,weaimtopresentanddiscusspossiblemechanisms1–3underlyingthisatypicalpresentationandtohighlightfrankmeningitisasanatypicalpresentingfeatureofanti-NMDA-receptorencephalitis.Cliniciansshouldconsiderautoimmuneencephalitidesinindividualswithmeningitis,particularlywhereextensiveinvestigationsfailtoidentifyacausativemicro-organismandthereisrapiddevelopmentofanencephaliticphenotype.Amultidisciplinaryapproachisrequiredtoaddresstheneurological,gynaecological,oncological,andneuropsychiatricaspectsofthischallengingandincompletelyunderstooddisorder.ReferencesBektaşÖ,etal.Neuropediatrics2014;45(6):396–401IraniSR,etal.Brain2010;133(Pt6):1655–67DalmauJ,etal.LancetNeurol2008;7(12):1091–8 http://dx.doi.org/10.1136/jnnp-2019-ABN-2.79 StatisticsfromAltmetric.com RequestPermissions IfyouwishtoreuseanyorallofthisarticlepleaseusethelinkbelowwhichwilltakeyoutotheCopyrightClearanceCenter’sRightsLinkservice.Youwillbeabletogetaquickpriceandinstantpermissiontoreusethecontentinmanydifferentways. Copyrightinformation: ©Author(s)(ortheiremployer(s))2019.Nocommercialre-use.Seerightsandpermissions.PublishedbyBMJ. ReadthefulltextordownloadthePDF: Subscribe Login LoginviaInstitutionLoginviaOpenAthens Loginusingyourusernameandpassword ForpersonalaccountsORmanagersofinstitutionalaccounts Username* Password* Forgotyourlogindetails?Registeranewaccount?Forgotyourusernameorpassword? ReadthefulltextordownloadthePDF: Subscribe Login LoginviaInstitutionLoginviaOpenAthens Loginusingyourusernameandpassword ForpersonalaccountsORmanagersofinstitutionalaccounts Username* Password* Forgotyourlogindetails?Registeranewaccount?Forgotyourusernameorpassword?

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