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Figure Clinical course of acute neuritis and NMDA receptor (NMDAR) encephalitis, sural nerve biopsy, and detection of NMDAR antibodies(A) Approximately.

Published byHelge Dresdner Modified over 5 years ago

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Presentation on theme: "Figure Clinical course of acute neuritis and NMDA receptor (NMDAR) encephalitis, sural nerve biopsy, and detection of NMDAR antibodies(A) Approximately."— Presentation transcript:

1 Figure Clinical course of acute neuritis and NMDA receptor (NMDAR) encephalitis, sural nerve biopsy, and detection of NMDAR antibodies(A) Approximately 3–4 weeks after onset of peripheral neuropathy, NMDAR antibody (ab) titers started to appear in CSF (red) and serum (blue). Clinical course of acute neuritis and NMDA receptor (NMDAR) encephalitis, sural nerve biopsy, and detection of NMDAR antibodies(A) Approximately 3–4 weeks after onset of peripheral neuropathy, NMDAR antibody (ab) titers started to appear in CSF (red) and serum (blue). NMDAR encephalitis showed response to immunotherapy with methylprednisolone (MP), IV immunoglobulin (IVIg), plasma exchange (PE), and rituximab. Curves for neuropathy and encephalitis demonstrate global clinical impression (arbitrary units) to visualize the sequence of clinical symptoms. mRS = modified Rankin Scale. (B–D) Patient's serum (green, Alexa Fluor 488, Jackson ImmunoResearch, Suffolk, UK) showed the typical pattern in rat hippocampus (dilution 1:400, B) and NMDAR-transfected HEK293 cells (C) but not control-transfected cells (D). Red nuclear stain was performed with TO-PRO-3 iodide (Invitrogen, Karlsruhe, Germany). (E.a) Semithin section stained by methylene blue illustrates severe reduction of myelinated fibers, affecting both thin and thickly myelinated fibers. Also, profound axonal loss (asterisks), acute axonal degeneration (arrows), and single axon regeneration clusters are visible (box E.b: higher magnification). (F) Teased fibers show short internodal segments (arrows). (G) Higher magnification demonstrates hypomyelinated and shortened segments (sign of demyelination) and alignment of ovoids (sign of acute axonal degeneration). Harald Prüss et al. Neurol Neuroimmunol Neuroinflamm 2014;1:e14 © 2014 American Academy of Neurology

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