F-18 fluorodeoxyglucose PET/CT findings in a case of anti-NMDA receptor encephalitis.

摘要

A 23-year-old woman with a history of rapid-cycling bipolar disorder was brought in by her family after 4 days of increasing psychological disturbance characterized by declining mental status, hallucinations, orofacial dyskinesias, and bizarre behavior. A paraneoplastic encephalopathy was suspected clinically, prompting whole-body and dedicated brain 2-de-oxy-2-[F-18]fluoro-D-glucose (FDG) positron emission tomography and computed tomography (PET/CT) imaging that showed relative hypometab-olism of the bilateral occipital lobes and cerebellum, and relative hyperme-tabolism of the bilateral frontal, temporal, and parietal lobes. Subsequent cerebrospinal fluid analysis demonstrated strongly positive anti-N-methyl-D-aspartate receptor (anti-NMDAR) autoantibody titers that, in conjunction with the patient's clinical presentation, were diagnostic of anti-NMDAR encephalitis. The FDG PET/CT appearance of anti-NMDAR encephalitis has not been previously characterized in the literature, and FDG PET/CT brain imaging findings from this patient with clinically confirmed anti-NMDAR encephalitis are presented here.