Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 16, 2023; 11(20): 4961-4965
Published online Jul 16, 2023. doi: 10.12998/wjcc.v11.i20.4961
Laryngospasm as an uncommon presentation in a patient with anti-N-methyl-D-aspartate receptor encephalitis: A case report
Lu Wang, Hong-Jun Su, Guan-Jie Song
Lu Wang, Hong-Jun Su, Guan-Jie Song, Department of Neurology, Tianjin Baodi Hospital, Tianjin 301800, China
Author contributions: Wang L contributed to the intellectual content and drafted the manuscript; Su HJ was responsible for the acquisition and interpretation of the data; Song GJ prepared the legends, updated the literature, and interpreted the results; All authors made a substantial contribution to the preparation of the manuscript and read and approved the final version of the manuscript.
Informed consent statement: Informed written consent was obtained from the patient and her parents for the publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Guan-Jie Song, MD, Associate Chief Physician, Department of Neurology, Tianjin Baodi Hospital, No. 8 Guangchuan Road, Tianjin 301800, China. songguanjiesgj@163.com
Received: April 30, 2023
Peer-review started: April 30, 2023
First decision: May 25, 2023
Revised: June 2, 2023
Accepted: June 26, 2023
Article in press: June 26, 2023
Published online: July 16, 2023
Abstract
BACKGROUND

Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a rare autoimmune disorder. The symptoms of anti-NMDAR encephalitis include behavioral problems, speech problems, psychosis, seizures, and memory deficits, among others. However, laryngospasm is rare. We present the case of a patient with anti-NMDAR antibodies and severe laryngospasms.

CASE SUMMARY

The patient was a 15-year-old female with normal psychomotor development. She was initially admitted to our neurological intensive care unit with seizures. She received anti-epilepsy treatment, and the seizures disappeared. However, 2 wk later, she developed behavioral problems and speech impairment. Then, she developed severe laryngospasms, which were treated with intubation and a tracheotomy. Antibodies against the NMDAR were detected in the patient’s cerebrospinal fluid. Therefore, she was diagnosed with anti-NMDAR encephalitis. In addition, she received intravenously administered immunoglobulins, and methylprednisolone was administered. The patient’s symptoms gradually improved, and she was discharged from our hospital. Approximately 9 mo later, the patient could speak sentences, walk independently, and carry out activities of daily living independently. Through our case report, we highlighted laryngospasm as an uncommon presentation in patients with anti-NMDAR encephalitis.

CONCLUSION

Laryngospasm may be an uncommon clinical manifestation of anti-NMDAR encephalitis.

Keywords: Anti-N-methyl-D-aspartate receptor, Laryngospasm, Encephalitis, Epilepsy, Immunotherapy, Case report

Core Tip: Laryngospasms are uncommonly reported in anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis. Herein, we report a rare case of a patient with anti-NMDAR encephalitis with severe laryngospasms. The patient was treated with intubation and tracheotomy. In addition, she received intravenously administered immunoglobulins, and methylprednisolone was administered. Nine months later, the patient could perform activities of daily living independently. We highlighted that patients with anti-NMDAR encephalitis may present with fatal laryngospasms. Further study of fatal laryngospasms secondary to anti-NMDAR encephalitis may be necessary in the future.