A 31-year-old woman with a rare condition - Auto-Immune Encephalitis leading to the inflammation of the brain misdiagnosed as a stroke was successfully treated by a team led Dr Pavan Pai, Consultant Interventional Neurologist, Wockhardt Hospitals, Mira Road.
The patient with symptoms such as right-side twisting movements, speech arrest, and imbalance is now symptom-free and leading a normal life.
Nikita Kumari, who is a resident of Mira Road, and a housewife by profession, visited Wockhardt Hospitals with complaints of right-side twisting movements of hands in July 2023. She had consulted various Neurologists, did an MRI, and was treated for a stroke. However, she had a facial and right upper limb focal seizure. Post that, she was examined by Dr Pavan Pai, and MRI done outside was opined as having an altered signal in the left temporal region of the brain by Dr Pradnya Shinde, Consultant Radiologist. Her CSF Autoimmune Encephalitis test showed NMDA receptor antibody. She was diagnosed with NMDA receptor autoimmune encephalitis and started on IV Immunoglobulin.
Dr Pavan Pai, Consultant Interventional Neurologist, Wockhardt Hospitals, Mira Road said “Autoimmune encephalitis is when antibodies are generated in the brain and nerve cells. When there is any viral infection, the body generates antibodies against the virus and bacteria. Sometimes, those antibodies have a molecular mimicry of our brain cells, and they start attacking the brain. This condition usually happens in younger patients of the age group 20-40 years. This condition mimics psychological problems such as depression. This is a rare condition and affects one out of 1.5 million people per year. She was put on anticonvulsants and started on IV Immunoglobulin after which she recovered completely.
Dr Pai added,” The patient conceived in October 2023 and stopped all the medication by herself as she felt alright. In December 2023, she had a miscarriage and in January 2024, the patient got unusual neurological symptoms such as speech arrest, she would forget what she was trying to tell. The patient had intermittent episodes of speech arrest and imbalance and walked in a straight line. A repeat MRI was done in January 2024, which showed new lesions in the brain. She was readmitted in the last week of January (after her admission in July 2023). Her CSF analysis was repeated in which the NMDA antibody was weakly positive. She was started on high-dose IV steroids and discharged on oral steroids and anticonvulsants. She was also given IV Rituximab to prevent relapse. This case has been immortalized in New York Times best-selling autobiography by New York Post writer Susannah Cahalan. The book details Cahalan's struggle with this rare form of encephalitis and her recovery. I have seen 3 such cases in the last 7-8 years. She is advised regular follow-ups and told to continue medications religiously. Not treating her at the right time could have led drug drug-resistant seizures and permanent damage to the brain."
"I was plunged into a relentless battle when diagnosed with autoimmune encephalitis, my world turned inside out as the debilitating recurrent episodes of symptoms took a toll on me. Wockhardt Hospitals, Mira Road became my beacon of hope, where the dedicated medical team led by Dr. Pavan Pai, expertly navigated the complex terrain of my condition. Through treatment and unwavering support, I found solace in their compassionate care. As I journeyed towards recovery, each day brought new revelations and triumphs in my fight against autoimmune encephalitis. The holistic approach of Wockhardt Hospital ensured that not only was my physical health tended to meticulously but also that my emotional well-being was prioritized. I am forever grateful to the Hospital,” concluded the patient Nikita Kumari.
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