Clinical Report: Uncommon Brainstem Involvement in Anti-mGluR1 Encephalitis
Background
Anti-metabotropic glutamate receptor 1 (mGluR1) encephalitis is a rare autoimmune condition often associated with cerebellar dysfunction. Instances of predominant brainstem involvement are infrequently documented.
Data Highlights
The patient exhibited subacute symptoms including fever, dysarthria, limb weakness, and altered mental status. Diagnostic tests confirmed anti-mGluR1 antibodies in serum and cerebrospinal fluid. MRI showed hyperintensity affecting the midbrain, pons, and medulla without diffusion restriction.
Key Findings
Anti-mGluR1 encephalitis can present with significant brainstem involvement.
The patient had a 9-day history of progressive neurological symptoms prior to diagnosis.
Diagnostic imaging revealed extensive hyperintensity in brainstem regions.
Next-generation sequencing of cerebrospinal fluid was negative for infectious agents.
Clinical Implications
Testing for anti-mGluR1 antibodies may be warranted in cases of unexplained subacute inflammatory brainstem syndromes.
Conclusion
This case highlights atypical presentations of anti-mGluR1 encephalitis with brainstem involvement.
This American Epilepsy Society (AES) practice guideline provides updated, evidence-based recommendations for the management of epilepsy in infants and children aged 1 month to <36 months.
