Case | 1 | 2 |
---|---|---|
Age | 42 | 55 |
Sex | Female | Female |
Diagnosis | Anti-NMDA receptor encephalitis | Anti-NMDA receptor encephalitis |
Neuropsychological symptoms | ||
AAAD (wrong age estimation) | Yes (17) | Yes (27) |
Disorientation | Yes | Yes |
Retrograde and anterograde amnesia | Yes | Yes |
Neuropsychological examination | ||
MMSEa | 15/30 | 26/30 |
WMS-Rb | ||
Verbal MQ | <50 | 94 |
Visual MQ | 111 | 97 |
General MQ | 71 | 94 |
Attention/Concentration | 97 | 79 |
Delayed recognition | 64 | 75 |
WAIS-IIIb | ||
Verbal IQ | 82 | 94 |
Performance IQ | 68 | 86 |
Full scale IQ | 72 | 89 |
Clinical examination | ||
CSF | 20 cells/mm3 (lymphocytes predominant) with normal protein levels | Normal cells, protein levels |
Elevated anti-NMDA receptor antibody titres | Elevated anti-NMDA receptor antibody titres | |
Blood | Elevated anti-NMDA receptor antibody titres | Elevated anti-NMDA receptor antibody titres |
Brain MRI | High intensity bilateral medial temporal lobe lesion (assessed by FLAIR) | No specific findings |
123I-IMP brain perfusion SPECT | Increase in bilateral medial temporal lobe blood flow; decrease in right orbitofrontal region blood flow | Bilateral increase in medial temporal lobe and orbitofrontal region blood flow |
EEG | Sporadic spike discharge and diffuse slow waves | No epileptic discharge |