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論文
- タイトル
- タイトル（英）
- Unexplained Progressive Neurological Deficits after Corpus Callosotomy May Be Caused by Autoimmune Encephalitis: A Case of Suspected Postoperative Anti-NMDAR Encephalitis.
- 参照URL
- https://researchmap.jp/childbrain/published_papers/41612190
- 著者
- 著者（英）
- Keisuke Hatano,Ayataka Fujimoto,Keishiro Sato,Takamichi Yamamoto,Hiroshi Sakuma,Hideo Enoki
- 担当区分
- 概要
- 概要（英）
- The main causes of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis are ovarian teratoma and herpes simplex virus (HSV) encephalitis. We present a rare case of suspected anti-NMDAR encephalitis caused by corpus callosotomy (CC). An 18-year-old woman with Lennox-Gastaut syndrome underwent CC. Although left hemiplegic due to cerebral hemorrhage and impaired consciousness due to cerebral venous sinus thrombosis (CVST) appeared postoperatively, anticoagulant therapy quickly improved CVST and impaired consciousness. However, various unexplained symptoms such as insomnia, hallucination, impulsivity, impaired consciousness, and a new type of drug-resistant cluster seizures gradually developed over a 2-month period. Magnetic resonance imaging revealed the gradual extension of a hyperintense area from the right frontal lobe on fluid-attenuated inversion recovery images. Intravenous methylprednisolone pulse was initiated from postoperative day (POD) 74, followed by intravenous immunoglobulin (IVIg) therapy, although white blood cell counts were normal in all three cerebrospinal fluid (CSF) examinations. After IVIg therapy, the above unexplained symptoms promptly improved. On POD 103, antibodies against NMDAR were revealed in both the serum and CSF collected before these immunotherapies. The patient was transferred to a rehabilitation hospital due to residual left hemiplegia. Psychiatric symptoms and a new onset of drug-resistant seizures may be suggestive of postoperative anti-NMDAR encephalitis, even if CSF findings are mild.
- 出版者・発行元
- 出版者・発行元（英）
- 誌名
- 誌名（英）
- Brain sciences
- 巻
- 13
- 号
- 1
- 開始ページ
- 終了ページ
- 出版年月
- 2023年1月12日
- 査読の有無
- 招待の有無
- 掲載種別
- ISSN
- DOI URL
- https://doi.org/10.3390/brainsci13010135
- 共同研究・競争的資金等の研究課題
研究者
佐久間 啓
(サクマ ヒロシ)