An adolescent patient with anti-N-methyl-D-aspartate receptor encephalitis with motor aphasia as the first symptom and complicated by peripheral nerve damage: A case report and literature review.

RATIONALE: Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a type of autoimmune encephalitis, and the common first symptoms are mental disorders, seizures, and rarely aphasia in patients. Meanwhile, movement disorders associated with anti-NMDAR encephalitis are usually chorea and dystonia, with peripheral nerve damage being rare.

PATIENT CONCERNS: We present a case of anti-NMDAR encephalitis with motor aphasia as the first symptom. The patient, a 16-year-old female, was admitted to the hospital with further progression of the disease, complicated by grand mal seizures with peripheral nerve damage.

DIAGNOSES: Anti-NMDAR encephalitis.

INTERVENTIONS: The patient accepted first-line therapy, including methylprednisolone and intravenous immunoglobulin shock therapy, rituximab second-line treatment (rituximab), and third-line therapies (mycophenolate mofetil), as well as efgartigimod as an additional therapy.

OUTCOMES: After 6 weeks of comprehensive treatment, the patient's muscle strength in both lower limbs recovered, and the psychiatric symptoms and seizures improved.

LESSONS: This case broadens the range of clinical symptoms of anti-NMDAR encephalitis, and we should recognize that motor aphasia may also be one of the first symptoms in adolescent patients with anti-NMDAR encephalitis. What's more, efgartigimod may be a promising treatment for patients with anti-NMDAR encephalitis.