Case Report: Anti-NMDA Receptor Encephalitis With Bilateral Hearing Loss as the Initial Symptom.

Hongjiang Cheng,Jing Zhang,Huimin Li,Fengbing Yang,Wei Liu,Lina Xu,Doudou Zhao,Longbin Jia

doi:10.3389/fneur.2021.648911

Hongjiang Cheng, Jing Zhang + Show 6 more

Open Access

https://doi.org/10.3389/fneur.2021.648911

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Abstract

Introduction: Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is an autoimmune disease associated with the NMDA receptor. This paper describes a patient who presented with bilateral hearing loss as the initial symptom of anti-NMDAR encephalitis.Case Report: We describe a 31-year-old young female with anti-NMDAR encephalitis who presented with bilateral severe hearing loss after brief loss of consciousness and then accompanied by other symptoms, such as generalized tonic–clonic seizures, manic episodes, excessive salivation, severe cognitive impairment, and complex non-convulsive status epilepticus. Great improvement was achieved by a combined treatment of steroid, IVIG, and plasmapheresis, especially after surgical removal of the ovarian teratoma. When she was discharged on hospital day 43, her hearing loss obtained a significant improvement.Conclusion: This case study and literature review investigated the impairment of hearing loss and its subsequent treatment in patients with anti-NMDAR encephalitis.

Highlights

Anti-N-methyl-D-aspartate receptor encephalitis is an autoimmune disease associated with the NMDA receptor
The results suggested that anti-NMDAR antibodies were still positive (1:30 serum, 1:100 cerebrospinal fluid (CSF))
Our patient presented with bilateral serious sensorineuronal hearing loss as the initial symptom and developed generalized tonic–clonic seizures and nonconvulsive status epilepticus

Summary

Introduction

Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is an autoimmune disease associated with the NMDA receptor. This paper describes a patient who presented with bilateral hearing loss as the initial symptom of anti-NMDAR encephalitis. Case Report: We describe a 31-year-old young female with anti-NMDAR encephalitis who presented with bilateral severe hearing loss after brief loss of consciousness and accompanied by other symptoms, such as generalized tonic–clonic seizures, manic episodes, excessive salivation, severe cognitive impairment, and complex non-convulsive status epilepticus. Great improvement was achieved by a combined treatment of steroid, IVIG, and plasmapheresis, especially after surgical removal of the ovarian teratoma. When she was discharged on hospital day 43, her hearing loss obtained a significant improvement

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