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

Anti-GlyR-Abs Encephalitis and MRI findings.

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.