A Rare Case of Anti-NMDA receptor encephalitis: CMV positivity, MTHFR 677T variant and hematoma on neuroimaging

Abstract

Herpes simplex virus (HSV) encephalitis represents the leading cause of severe encephalitis in the pediatric population. Recurrence of clinical manifestations is rarely observed. Recurrence is thought to result from secondary autoimmune processes rather than active viral infection. One of the most common etiologies of autoimmunity is anti-NMDA receptor encephalitis. Early recognition is essential for patient outcome in this treatable autoimmune encephalitis. Patients typically present with abnormal behavior and posture, speech disturbances, seizures, movement disorders, dyskinesias, and altered levels of consciousness. We describe a 21-month-old male presenting with fever, diarrhea, vomiting, seizures, and movement disorders.