Overlap syndromes of these two disease entities have been reported, i.e. Patients with NMDAR encephalitis usually present with a clinical syndrome including psychosis, behavioural changes, amnesia and epileptic seizures, frequently followed by dyskinesia and decreased levels of consciousness, while patients with MOG associated disorders typically present with a demyelinating syndrome reaching from ADEM-like phenotype to isolated syndromes, such as myelitis or optic neuritis. Antibody dynamics were associated with clinical disease course.Īnti-N-methyl-D-aspartate-receptor (NMDAR) encephalitis and Myelin Oligodendrocyte Glycoprotein (MOG) associated disorders are both immune-mediated inflammatory disorders of the central nervous system. We provide long-term longitudinal follow-up of a patient with anti-NMDA receptor encephalitis who developed triple antibody positivity at the time of relapse. Anti-Caspr2 antibodies persisted, anti-NMDA receptor antibodies decreased, while anti-MOG antibodies turned negative again. Treatment with plasmapheresis, steroids and rituximab eventually led to substantial clinical and radiological improvement. At this time, the patient developed anti-MOG and anti-Caspr2 antibodies. Forty-four months after symptom onset and diagnosis of autoimmune encephalitis, he suffered from relapse. We report a 32-year-old male patient who presented with psychosis, decreased consciousness and movement disorders and was tested positive for anti-NMDA receptor antibodies. In this case we provide a long-term longitudinal follow-up of clinical and imaging characteristics as well as of antibody dynamics. Overlap syndromes of anti-NMDA receptor encephalitis and MOG-mediated demyelination have been reported.
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