case_images: PMC11063230_01
case_images: Brain magnetic resonance imaging (MRI) at the time of pre-onset (A1,A2, Oct 4, 2022 date), ongoing disease (B1,B2, Feb 3, 2023 date) and post-immunotherapy (C1,C2, Feb 22, 2023 date). T2-weighted fluid-attenuated inversion recovery (FLAIR) sequence in the axial orientation shows normal brain parenchyma (A1,A2). multiple patchy long T2 signals in the white matter of the bilateral deep frontal lobe (B1), and in the left temporal lobe, insula lobe and right deep frontal lobe (B2). Repeat MRI shows marked reduction in the area of the frontal lobe and the left temporal lobe after immunotherapy (C1,C2). Arrows indicate focal lesions.
case_images: fneur-15-1356691-g001.jpg
case_images: PMC11063230_01_fneur-15-1356691-g001.jpg
case_images: fig1
case_images: Brain MRI displayed multifocal lesions in subcortical areas (Figures 1B1,B2) that were not presented 4 months ago (Figures 1A1,A2). Her symptoms eased noticeably and she restored to her normal mental status. 19 days after the treatment, an MRI review of her head showed that most lesions had decreased or disappeared in previous examinations (Figures 1C1,C2).
case_images: Spinal MRI performed with T2-weighted sagittal (A,B) and axial (C,D) views (Feb 8, 2023 date). There are multiple short segment lesions in the spinal cord and subdural hematoma at T1, T6-T7 posterior. Arrows indicate focal lesions.
case_images: fneur-15-1356691-g002.jpg
case_images: PMC11063230_01_fneur-15-1356691-g002.jpg
case_images: fig2
case_images: An MRI scan of the spinal cord was then performed, revealing multiple swollen short lesions in the thoracic cord accompanied by a subdural hematoma (Figures 2A-D).
case_images: Timeline of clinical events, diagnostic work-up and treatment during the disease course. MRI magnetic resonance imaging; MMF mycophenolate mofetil; EDSS Expanded Disability Status Scale; AE autoimmune encephalitis; GlyR-Abs glycine receptor antibodies; IVMP Intravenous methylprednisolone; IVIG intravenous immunoglobulins.
case_images: fneur-15-1356691-g003.jpg
case_images: PMC11063230_01_fneur-15-1356691-g003.jpg
case_images: fig3
case_images: We also organized patient clinical events, diagnostic work-up, and treatment options as a timeline (Figure 3).