AN UNCOMMON CAUSE OF BRAINSTEM ENCEPHALITIS WITH SPONTANEOUS REMISSION: ANTI-GLYCINE RECEPTOR ANTIBODY ENCEPHALITIS

Anti-GlyR-Abs Encephalitis and MRI findings.

Authors

  • Aikaterini Theodorou ATTIKON UNIVERSITY HOSPITAL
  • John S. Tzartos
  • Konstantinos Markakis
  • Matilda Papathanasiou
  • Ioanna Tsantzali
  • Anastasios Bonakis
  • Maria Chondrogianni
  • Dimitrios Kitsos
  • Chrisa Arvaniti
  • Stauroula Salakou
  • Georgios Tsivgoulis
  • Konstantinos Voumvourakis

Keywords:

Brainstem Encephalitis, MRI, Glycine Receptor Antibody

Abstract

A 67-year-old man with diabetes mellitus presented due to epileptic seizures and acute psychosis. During
hospitalization painful spasms of upper-limb- and thoracic-muscles were developed. Diffuse T2/FLAIRhyperintense
lesion in central pons and cerebral-peducles with diffusion-restriction, microhemorrhages and gadolinium enhancement was depicted in brain-MRI. Electrolyte levels were within normal range
and further diagnostic work-up, including rheumatic/infectious/neoplastic diseases was negative. The
patient showed spontaneous clinical improvement without specific treatment, before the screening for
autoimmune diseases was complete. GlyR-Abs were positive only in serum, leading to the diagnosis of
brainstem-encephalitis. This case highlights the radiological findings of brainstem-encephalitis with positive
GlyR-Abs and spontaneous remission.

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Published

2023-07-19