F-18 FDG Brain PET in a Para-Neoplastric Syndrome Patient with Anti NMDA Receptor Encephalitis

Abstract

The encephalitis associated with antibodies (Ab) against the N-Methyl-D-Aspartate Receptor (NMDAR) was first discovered in 2007 [1]. Since then, there have been several reports on clinical features and diagnostic tools for better understanding the pathophysiology of this disease. Magnetic Resonance Imaging (MRI), Magnetic Resonance Spectroscopy (MRS), Electroencephalogram (EEG), Fluoro-2-Deoxy- D-Glucose Positron Emission Tomography (FDG PET), and Single Photon Emission Computed Tomography (SPECT) with 99mtc-D,LHexamethyl- Propyleneamine Oxime (HMPAO) have shown a variety of abnormal findings but with no conclusion of characteristic features. High serum Ab titer for NMDA receptor and abnormal Cerebrospinal Fluid (CSF) evaluation are present in majority of the patients [2] and have been considered the diagnostic standard. However, noninvasive imaging diagnostic evaluation of this syndrome has not been established yet.