Table 2.
Previous case reports demonstrating the characteristics of patients with overlapping MS and anti-NMDAR encephalitis.
| CASES | CASE1 | CASE2 | CASE3 | CASE4 | CASE5 | CASE6 | CASE7 | CASE8 | CASE9 | CASE10 | CASE11 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Year | 2010 | 2012 | 2014 | 2015 | 2015 | 2017 | 2017 | 2018 | 2020 | 2020 | 2021 |
| Country | England | Japan | Germany | Germany | Austria | England | England | England | Turkey | China | China |
| Author | Johnston et al. (21) | Uzawa et al. (22) | Wachbisch et al. (23) | Fleishmann et al. (8) | Ramberger et al. (19) | Baheerathan et al. (24) | Baheerathan et al. (24) | Suleman et al. (25) | Gulec et al. (26) | Huang et al. (27) | Our case |
| Age/sex | 32/F | 33/F | 33/M | 33/F | 23/F | 32/F | 29/M | 41/F | 26/F | 19/F | 16/F |
| Course | MS→NMDAR | MS→NMDAR | MS→NMDAR | MS→NMDAR | MS→NMDAR | NMDAR→MS | NMDAR→MS | MS→NMDAR | MS→NMDAR | MS→NMDAR | IDDs→ NMDAR→MS |
| NMDAR Encephalitis symptoms | Seizures, disorders of consciousness | Seizures, psychosis | Tonic spasms, paroxysmal tingling | Cognitive dysfunction, memory lost | Psychosis | Seizures, abnormal movements, and encephalopathy | Seizures, psychosis | Psychosis | Seizures, disorders of consciousness, agitation, hallucinations | Seizures, psychosis, sleep disorders | Disorders of consciousness, cognitive dysfunction |
| Multiple Sclerosis symptoms | Optic neuritis, right trigeminal sensory disturbance, dyskinesia | Optic neuritis, spinal cord and brainstem symptoms | Left hemiparesis | Paresthesia, reduced visual acuity, ataxia, dysphonia | Limb weakness, optic neuritis | Diplopia, facial weakness, and cerebellar ataxia | Limb weakness numbness | / | Limb weakness | Right eye visual loss and left limb paralysis | Limb weakness, diplopia |
| CSF NMDAR antibody | / | Positive | Negative | Positive | Positive | / | Positive | / | Negative | Positive | Positive |
| Serum NMDAR antibody | Positive | Negative | Positive | Positive | Positive | Positive | Positive | Positive | Positive | Positive | Negative |
| OCB | / | Positive | Positive | Positive | Positive | Negative | Positive | Positive | Positive | Positive | Positive |
| MRI findings | MS lesion beside lateral ventricle | Temporal lobe lesion, lateral ventricle MS lesion | MS lesion beside lateral ventricle with enhancement | Paraventricular MS lesions with enhancement, global brain atrophy, large paraventricular confluent lesions, brainstem and cervical spinal cord lesions. | MS lesion beside lateral ventricle | Demyelinating brain and spinal cord lesions | Demyelinating brain and spinal cord lesions | Demyelinating brain lesion | MS lesion beside lateral ventricle with enhancement | MS lesion beside lateral ventricle with enhancement | Multiple lesions in white matter |
| Tumor | No | No | No | No | No | No | No | No | No | No | No |
| Treatment | GC | GC | GC, rituximab | GC, PE, CP, natalizumab, | / | DMT | Improved spontaneously without immunotherapy | GC, IVIg, rituximab | Interferone-b1a, fingolimod, natalizumab, teriflunomide, PE, IVIg, HDMP, rituximab | IVIg, HDMP | HDMP, IVIg, PE, AZA, MMF, GC, teriflunomide |
| NMDAR antibody evolution | / | / | / | Decreased | Increased | Negative | Negative | / | Decreased | / | Negative |
| Prognosis | Recovery | Recovery | Recovery | Death | / | Free of relapses | / | Problems with short-term memory | Recovery | Recovery | Recovery |
| Follow-up time | / | 6 months | 12 months | 6 months | / | 10 months | / | / | 12 months | / | 18 months |
OCB, oligoclonal band; IVIg, intravenous immunoglobulin; AZA, azathioprine; HDMP, high-dose methylprednisolone; MMF, mycophenolate mofetil; GC, glucocorticoid; PE, plasma exchange; DMT, disease modifying treatment; IDDs, inflammatory demyelinating diseases.