Skip to main content
Advertisement
  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Education
    • Genetics
    • Neuroimmunology & Neuroinflammation
  • Online Sections
    • Neurology Video Journal Club
    • Diversity, Equity, & Inclusion (DEI)
    • Neurology: Clinical Practice Accelerator
    • Practice Buzz
    • Practice Current
    • Residents & Fellows
    • Without Borders
  • Collections
    • COVID-19
    • Disputes & Debates
    • Health Disparities
    • Infographics
    • Neurology Future Forecasting Series
    • Null Hypothesis
    • Patient Pages
    • Topics A-Z
    • Translations
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit New Manuscript
    • Submit Revised Manuscript
    • Author Center

Advanced Search

Main menu

  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Education
    • Genetics
    • Neuroimmunology & Neuroinflammation
  • Online Sections
    • Neurology Video Journal Club
    • Diversity, Equity, & Inclusion (DEI)
    • Neurology: Clinical Practice Accelerator
    • Practice Buzz
    • Practice Current
    • Residents & Fellows
    • Without Borders
  • Collections
    • COVID-19
    • Disputes & Debates
    • Health Disparities
    • Infographics
    • Neurology Future Forecasting Series
    • Null Hypothesis
    • Patient Pages
    • Topics A-Z
    • Translations
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit New Manuscript
    • Submit Revised Manuscript
    • Author Center
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Neurology Video Journal Club
  • Residents & Fellows

User menu

  • Subscribe
  • My Alerts
  • Log in

Search

  • Advanced search
Neurology
Home
The most widely read and highly cited peer-reviewed neurology journal
  • Subscribe
  • My Alerts
  • Log in
Site Logo
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Neurology Video Journal Club
  • Residents & Fellows

Share

August 11, 2015; 85 (6) Resident and Fellow Section

Teaching NeuroImages: NMDA encephalomyelitis with MRI abnormalities isolated to ventral spinal cord gray matter

Sarah Zubkov, Puja Aggarwal Joshi, Timothy M. Shepherd, Sanjeev V. Kothare
First published August 10, 2015, DOI: https://doi.org/10.1212/WNL.0000000000001839
Sarah Zubkov
From NYU Langone Medical Center, New York, NY.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Puja Aggarwal Joshi
From NYU Langone Medical Center, New York, NY.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Timothy M. Shepherd
From NYU Langone Medical Center, New York, NY.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Sanjeev V. Kothare
From NYU Langone Medical Center, New York, NY.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Full PDF
Citation
Teaching NeuroImages: NMDA encephalomyelitis with MRI abnormalities isolated to ventral spinal cord gray matter
Sarah Zubkov, Puja Aggarwal Joshi, Timothy M. Shepherd, Sanjeev V. Kothare
Neurology Aug 2015, 85 (6) e55-e56; DOI: 10.1212/WNL.0000000000001839

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Permissions

Make Comment

See Comments

Downloads
1276

Share

  • Article
  • Figures & Data
  • Info & Disclosures
Loading

A 17-year-old girl presented with a month of anxiety followed by acute psychosis, catatonia, choreoathetosis, seizures, autonomic instability, lower extremity spasticity, and hyperreflexia. CSF was positive for the NMDA antibody; additional antibodies and infectious etiologies tested negative. MRI brain was normal. MRI spine revealed symmetric T2 hyperintensities in ventral gray matter (figure). EEG showed extreme delta brush. She received the following sequentially: IV gammaglobulin, methylprednisolone, ovarian teratoma resection, and plasmapheresis, only improving after rituximab. At 3 months, repeat MRI spine and motor examination results were normal. NMDA encephalitis with myelopathy is rare1,2; spinal cord gray matter involvement has not been reported previously.

Figure
  • Download figure
  • Open in new tab
  • Download powerpoint
Figure MRI spinal cord without contrast

The brain appeared normal on MRI (A) whereas sagittal cervical MRI (B) demonstrated subtle T2 hyperintensity in the ventral C4-C7 spinal cord that correlated axially with symmetric T2 hyperintensities in the ventral gray matter (C). There was no corresponding contrast enhancement. Repeat MRI after resolution of myelopathy appeared normal (D).

AUTHOR CONTRIBUTIONS

Sarah Zubkov: drafting and revision of manuscript, clinical care of patient. Puja Aggarwal Joshi: clinical care of patient, revision of manuscript. Timothy M. Shepherd: interpretation and preparation of images, revision of manuscript. Sanjeev V. Kothare: clinical care of patient, revision of manuscript.

STUDY FUNDING

No targeted funding reported.

DISCLOSURE

The authors report no disclosures relevant to the manuscript. Go to Neurology.org for full disclosures.

Footnotes

  • Download teaching slides: Neurology.org

  • © 2015 American Academy of Neurology

REFERENCES

  1. 1.↵
    1. Kruer MC,
    2. Koch TK,
    3. Bourdette DN,
    4. et al
    . NMDA receptor encephalitis mimicking seronegative neuromyelitis optica. Neurology 2010;74:1473–1475.
    OpenUrlFREE Full Text
  2. 2.↵
    1. Pennington C,
    2. Livingstone S,
    3. Santosh C,
    4. et al
    . N-methyl d-aspartate receptor antibody encephalitis associated with myelitis. J Neurol Sci 2012;317:151–153.
    OpenUrlPubMed
View Abstract

Letters: Rapid online correspondence

No comments have been published for this article.
Comment

REQUIREMENTS

You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.

Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.

If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.

Submission specifications:

  • Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
  • Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
  • Submit only on articles published within 6 months of issue date.
  • Do not be redundant. Read any comments already posted on the article prior to submission.
  • Submitted comments are subject to editing and editor review prior to posting.

More guidelines and information on Disputes & Debates

Compose Comment

More information about text formats

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
NOTE: The first author must also be the corresponding author of the comment.
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g. higgs-boson@gmail.com
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Publishing Agreement
NOTE: All authors, besides the first/corresponding author, must complete a separate Publishing Agreement Form and provide via email to the editorial office before comments can be posted.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

You May Also be Interested in

Back to top
  • Article
    • AUTHOR CONTRIBUTIONS
    • STUDY FUNDING
    • DISCLOSURE
    • Footnotes
    • REFERENCES
  • Figures & Data
  • Info & Disclosures
Advertisement

Safety and Efficacy of Tenecteplase and Alteplase in Patients With Tandem Lesion Stroke: A Post Hoc Analysis of the EXTEND-IA TNK Trials

Dr. Nicole Sur and Dr. Mausaminben Hathidara

► Watch

Topics Discussed

  • Autoimmune diseases
  • Encephalitis
  • MRI
  • Transverse myelitis

Alert Me

  • Alert me when eletters are published

Recommended articles

  • Research Article
    Clinical, Neuroimmunologic, and CSF Investigations in First Episode Psychosis
    Mar Guasp, Eloi Giné-Servén, Estibaliz Maudes et al.
    Neurology, May 12, 2021
  • Special Article
    NMDA receptor encephalitis and other antibody-mediated disorders of the synapse
    The 2016 Cotzias Lecture
    Josep Dalmau et al.
    Neurology, December 05, 2016
  • Articles
    Anti-NMDA receptor encephalitis in Japan
    Long-term outcome without tumor removal
    T. Iizuka, F. Sakai, T. Ide et al.
    Neurology, September 26, 2007
  • Article
    Neuroleptic intolerance in patients with anti-NMDAR encephalitis
    Florian Lejuste, Laure Thomas, Géraldine Picard et al.
    Neurology: Neuroimmunology & Neuroinflammation, August 29, 2016
Neurology: 100 (22)

Articles

  • Ahead of Print
  • Current Issue
  • Past Issues
  • Popular Articles
  • Translations

About

  • About the Journals
  • Ethics Policies
  • Editors & Editorial Board
  • Contact Us
  • Advertise

Submit

  • Author Center
  • Submit a Manuscript
  • Information for Reviewers
  • AAN Guidelines
  • Permissions

Subscribers

  • Subscribe
  • Activate a Subscription
  • Sign up for eAlerts
  • RSS Feed
Site Logo
  • Visit neurology Template on Facebook
  • Follow neurology Template on Twitter
  • Visit Neurology on YouTube
  • Neurology
  • Neurology: Clinical Practice
  • Neurology: Education
  • Neurology: Genetics
  • Neurology: Neuroimmunology & Neuroinflammation
  • AAN.com
  • AANnews
  • Continuum
  • Brain & Life
  • Neurology Today

Wolters Kluwer Logo

Neurology | Print ISSN:0028-3878
Online ISSN:1526-632X

© 2023 American Academy of Neurology

  • Privacy Policy
  • Feedback
  • Advertise