The condition, typically seen in young women with underlying ovarian teratomas, is exceptionally uncommon in elderly males, making this case a significant milestone
Image for representational purpose only. Photo Courtesy: File pic
A Thane hospital recently successfully treated an elderly man with a rare and challenging case of NMDA receptor positive autoimmune encephalitis.
The condition, typically seen in young women with underlying ovarian teratomas, is exceptionally uncommon in elderly males, making this case a significant milestone by treating the 73-year-old successfully at Jupiter Hospital.
The patient, who had a history of diabetes mellitus (DM), hypertension (HTN), and carcinoma bladder (post-TURP), presented severe neurological symptoms including headache, confusion, drowsiness, and orofacial dyskinetic movements.
Initial investigations, including CT and MRI scans, ruled out acute infarct or bleed. Further testing confirmed NMDA receptor positive autoimmune encephalitis (both CSF and serum).
The patient underwent an intensive treatment protocol, starting with high-dose steroids (1 gm Solumedrol IV for 3 days) followed by five cycles of Intravenous Immunoglobulin (IVIG) therapy.
This multidisciplinary approach, involving specialists from neurology, endocrinology, psychiatry, and critical care, played a crucial role in stabilising the patient’s condition.
Dr Yogesh Godge, consultant neurologist at the hospital said, “NMDA receptor encephalitis is rare in elderly males and requires high clinical suspicion for early diagnosis. Prompt initiation of steroids and IVIG therapy can be life-saving, as seen in this case. The patient responded well to treatment and is now on the path to recovery."
Echoing the importance of a comprehensive internal medicine strategy, Dr Javal Bhatt, consultant, Internal Medicine, at the hospital, added, “Managing such a complex case involved carefully balancing the patient’s multiple comorbidities while targeting the underlying autoimmune process. Timely coordination between departments was key to a positive outcome.”
Following the completion of therapy, the patient has shown significant improvement — becoming conscious, responsive, and able to follow commands — marking a successful recovery phase despite the rarity and severity of the condition.
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