Paroxysmal speech disorder as the initial symptom in a young adult with anti-N-methyl-D-aspartate receptor encephalitis: A case report

Table 1 Comparing the present case with that from Finke et al[18]

Item	The present case	Finke et al[18]
Age (yr)	39	67
Gender	Male	Male
History of past illness	No	Migraine with aura
Vascular risk factors	No	No
Initial paroxysmal symptoms	Nonfluent aphasia	Right homonymous hemianopia, global aphasia and right hemiparesis
Accompanying symptoms	Generalized tonic-clonic seizures	Throbbing bilateral headaches, confusion and agitation
CSF analysis	Mild pleocytosis (28 cells/μL) dominated by lymphocytes (85%) and elevated protein (662 mg/L)	Lymphocytic pleocytosis (95 cells/mL) with few activated lymphocytes and plasma cells and elevated protein (96 mg/dL)
Brain MRI	No lesions	Mild frontoparietal microangiopathic leucoencephalopathy
EEG	No epileptic discharges	First: Moderate generalized slowing; r: Normal
Tumor screening	Negative	Negative
Testing for anti-NMDAR antibodies	IgG NMDAR antibodies in both CSF (titer, 1:10) and serum (titer, 1:32)	IgG NMDAR antibodies in CSF (titer, 1:32), but not serum
Treatment	Intravenous immunoglobulin and methylprednisolone, followed by oral methylprednisolone	Oral corticosteroids and plasma exchange, followed by azathioprine
Outcome	Asymptomatic	No further episodes occurred, but verbal long-term memory deficit persisted

MRI: Magnetic resonance imaging; CSF: Cerebrospinal fluid; EEG: Electroencephalogram; NMDAR: N-methyl-D-aspartate receptor.