7-yo African-American male with seizures. No fever.
Initial CT scan and labs: normal.
EEG: diffuse slowing over the left cerebral hemisphere.
Brain Biopsy (left temporal lobe): Focal necrosis, dystrophic calcification, chronic inflammation, and microglial activation (the latter suggested an infectious etiology, such as a virus, but no infectious agent was identified).
Two weeks after initial work-up he was found to have +NMDA receptor antibodies.
As part of the search for the etiology of these NMDA receptor antibodies, a testicular ultrasound, Beta-HC, AFP, PET were performed to r/o malignancy — all of these studies were negative. CT of chest, abdomen, and pelvis also showed no masses but we know that approximately 40% of anti-NMDA receptor antibodies are found in the absence of a tumor.
We are interested in finding out if someone else has seen this rare condition.
