Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Med Cases and Elmer Press Inc
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Case Report

Volume 6, Number 10, October 2015, pages 468-471

A Neuropsychiatric Presentation of Seronegative Autoimmune Encephalitis: A Case Report


Figure 1.
Figure 1. Timeline of the case report.


Table 1. List of Investigations and Results
MRI: magnetic resonance imaging; EEG: electroencephalography; US: ultrasound; CT TAP: CT thorax, abdomen, and pelvis; CTPA: CT pulmonary angiography; CSF: cerebrospinal fluid; WCC: white cell count; HSV: herpes simplex virus; RNA: ribonucleic acid; VZV: varicella zoster virus.
Imaging, EEG and CSF analysis
  Brain CT1No abnormalities detected
  Brain MRI2, 4No abnormalities detected
  Pelvic US7No abnormalities detected
  EEG1, 2Moderate to severe encephalopathy, no delta brush
  CT TAP3No abnormalities detected
  CTPA14No abnormalities detected
  CSF microscopy1WCC = 78/mm3 (100% lymphocytes), glucose and total protein = normal range
  CSF microscopy6WCC = 7/mm3 (no differentials), glucose and total protein = normal range
Infection markers
  CSF viral screen (HSV1, HSV2, measles RNA, mumps RNA, VZV, enterovirus RNA)1, 6, 17, 22Negative
  CSF culture and sensitivity1, 6, 17, 22Negative
  Anti-extractable nuclear antibody4Negative
  Syphilis total antibody4Negative
  Anti-streptolysin (ASO) titer4Negative
  Hepatitis C antibodies, hepatitis B surface antigens13Negative
  Lyme disease serology15, 53Negative
Autoimmune, paraneoplastic and metabolic markers
  Anti-Yo and anti-Hu9Negative
  CEA19.9, CA125, CA15.39Negative
  Prophyria screen20Negative
  Ceruplasmin and copper4Normal range
  CSF and serum NMDA-R, VGKC, AMPAR-a, AMPAR-b, GABA-b receptor antibodies4Negative
  Anti-neutrophil cyto ab, anti-nuclear ab, anti-mitochondrial ab, anti-smooth mucle ab, anti-gastric parietal cell ab, anti-thyroid peroxidase ab4Negative
  CSF immunoglobulin (IgG)17, 22Intrathecal IgG elevated, no oligoclonal bands detected