We present an atypical case of relapsed anti-NMDAR encephalitis in a young female patient without an associated ovarian teratoma. She presented with recurrent seizure attacks with muscle weakness, psychosis, dyskinesia, autonomic failure and insomnia. She was first misdiagnosed as mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS) then Hashimoto's encephalopathy due to diffuse cerebral lesions, elevated serum lactic acid concentration, increased amount of thyroid peroxidase and thyroglobulin antibodies in serum and diffuse lesions of the thyroid gland. Her final diagnosis was delayed for 6 months with the detection of anti-NMDAR antibodies in her CSF. After treatment, she had poor recovery with serious sequelae at 10-month follow-up. Noteworthy, MELAS should be highlighted as a differential diagnosis of anti-NMDAR encephalitis. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
基金：
Youth Foundation of China-Japan Friendship Hospital [2015-1-QN-12]; Research Fund of the China-Japan Friendship Hospital [2013-RC-3]
第一作者单位：[1]Department of Neurology, China-Japan Friendship Hospital, Beijing, 100029, China
通讯作者：
推荐引用方式(GB/T 7714)：
Zhang Weihe,Yan Li,Jiao Jinsong.Repeated misdiagnosis of a relapsed atypical anti-NMDA receptor encephalitis without an associated ovarian teratoma[J].NEUROSCIENCE LETTERS.2017,638:135-138.doi:10.1016/j.neulet.2016.11.057.
APA：
Zhang, Weihe,Yan, Li&Jiao, Jinsong.(2017).Repeated misdiagnosis of a relapsed atypical anti-NMDA receptor encephalitis without an associated ovarian teratoma.NEUROSCIENCE LETTERS,638,
MLA：
Zhang, Weihe,et al."Repeated misdiagnosis of a relapsed atypical anti-NMDA receptor encephalitis without an associated ovarian teratoma".NEUROSCIENCE LETTERS 638.(2017):135-138
