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KMID : 1197720220150010066
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대한파킨슨병 및 이상운동질환 학회지
2022 Volume.15 No. 1 p.66 ~ p.70
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Parainfectious Anti-Glial Fibrillary Acidic Protein-Associated Meningoencephalitis
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Joo Jae-Young
Yoo Dal-Lah
Ahn Tae-Beom
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Abstract
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Movement disorders associated with glial fibrillary acidic protein (GFAP) autoantibodies have rarely been reported as ataxia or tremors. A 32-year-old man with headache and fever, initially diagnosed with viral meningoencephalitis, showed gradual improvement with empirical treatment. Two weeks after the illness, he suddenly developed orofacial, tongue, and neck dyskinesia accompanied by oculomotor abnormalities, which developed into severe generalized choreoballism. Brain magnetic resonance imaging (fluid-attenuated inversion recovery) showed signal hyperintensities in the bilateral globus pallidus interna. The clinical picture suggested an acute inflammatory trigger of secondary autoimmune encephalitis. The autoimmune antibody test was positive for GFAP, with the strongest reactivity in the cerebrospinal fluid (CSF) before treatment and decreased reactivity in serial CSF examinations during immunotherapy. Dyskinesia gradually improved to the extent that it could be controlled with only oral medications. This patient presented with parainfectious GFAP meningoencephalitis with distinctive clinical features and imaging findings.
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KEYWORD
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Autoimmune encephalitis, Choreoballism, Dyskinesia, Glial fibrillary acidic protein (GFAP)
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