either MOG immunoglobulin G (IgG) and demyelinating aspects have been found in patients with anti-NMDAR encephalitis, or vice versa NMDAR IgG in patients with demyelinating CNS disease. Overlap syndromes of these two disease entities have been reported, i.e. Patients with NMDAR encephalitis usually present with a clinical syndrome including psychosis, behavioural changes, amnesia and epileptic seizures, frequently followed by dyskinesia and decreased levels of consciousness, while patients with MOG associated disorders typically present with a demyelinating syndrome reaching from ADEM-like phenotype to isolated syndromes, such as myelitis or optic neuritis. Antibody dynamics were associated with clinical disease course.Īnti-N-methyl-D-aspartate-receptor (NMDAR) encephalitis and Myelin Oligodendrocyte Glycoprotein (MOG) associated disorders are both immune-mediated inflammatory disorders of the central nervous system. We provide long-term longitudinal follow-up of a patient with anti-NMDA receptor encephalitis who developed triple antibody positivity at the time of relapse.

Anti-Caspr2 antibodies persisted, anti-NMDA receptor antibodies decreased, while anti-MOG antibodies turned negative again. Treatment with plasmapheresis, steroids and rituximab eventually led to substantial clinical and radiological improvement. At this time, the patient developed anti-MOG and anti-Caspr2 antibodies. Forty-four months after symptom onset and diagnosis of autoimmune encephalitis, he suffered from relapse. We report a 32-year-old male patient who presented with psychosis, decreased consciousness and movement disorders and was tested positive for anti-NMDA receptor antibodies. In this case we provide a long-term longitudinal follow-up of clinical and imaging characteristics as well as of antibody dynamics. Overlap syndromes of anti-NMDA receptor encephalitis and MOG-mediated demyelination have been reported.

Anti nmo and anti mog