Anti-NMDA receptor encephalitis MRI

In approximately 50% of cases, brain magnetic resonance imaging (MRI) may appear normal in Anti-NMDA receptor encephalitis. Non-specific abnormalities, such as temporal lobe involvement, can be observed in the remaining cases. However, neuroimaging alone is not sufficient for diagnosis due to the lack of specific patterns of brain involvement.

In fifty percent of instances, magnetic resonance (MR) imaging of the brain is unremarkable. MRI scans may show non-specific abnormalities, with temporal lobe involvement being one of the most commonly reported findings. These findings are not specific to anti-NMDA encephalitis and can also be seen in other conditions.

T2-Weighted and Fluid-Attenuated Inversion Recovery (FLAIR) Sequences: In the remaining 50%, MR Imaging may demonstrate nonspecific T2 or fluid-attenuated inversion recovery (FLAIR) signal hyperintensity in the hippocampus; cerebellar, frontobasal, or insular cortex; basal ganglia; brainstem; and, rarely, the spinal cord.

The presence of bilateral medial temporal lobe hyperintensities, in particular, has been reported in some cases.

Anti-NMDAR encephalitis is notoriously difficult to diagnose based only on neuroimaging characteristics, as there are no discernible patterns of brain involvement

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