Key result
A 44-year-old woman developed acute flaccid myelitis with profound psychiatric symptoms and dysautonomia, initially mimicking anti-N-methyl-D-aspartate receptor encephalitis.
Case Report (n=1)
Highlights a rare case of acute flaccid myelitis presenting with dysautonomia and cardiac arrest requiring pacing, mimicking NMDAR encephalitis.
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A 44-year-old woman with a subacute onset of an altered mental status, urinary retention, and fluctuating blood pressure was initially diagnosed with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis, meeting the criteria of Graus et al. Cardiac arrest occurred, which required pacemaker placement. She subsequently showed profound flaccid limb paralysis, with magnetic resonance imaging demonstrating focal necrotic lesions localized in the anterior horn of the longitudinal segments of the spinal cord and in the pontine tegmentum. Enteroviruses or autoimmune encephalitis-associated autoantibodies were not detected. We herein report a case of acute flaccid myelitis with profound psychiatric symptoms and dysautonomia, resembling NMDAR encephalitis.
Warrants spinal imaging in anti-NMDAR encephalitis with flaccid paralysis; leaves open whether this represents a distinct encephalomyelitis overlap.
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Sumikura et al. (2024) conducted a case report in Acute flaccid myelitis accompanied by rhombencephalitis (n=1). A 44-year-old woman developed acute flaccid myelitis with profound psychiatric symptoms and dysautonomia, initially mimicking anti-N-methyl-D-aspartate receptor encephalitis.
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