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DOI: 10.1590/0004-282X20180047
Opisthotonus (arc de cercle) in anti-NMDAR encephalitis
Opistótono (arc de cercle) em um caso de encefalite anti-NMDAR
A 21-year-old man presented with focal-onset seizures with evolution to bilateral tonic-clonic seizures, fever, and encephalopathy. In our hospital, he was diagnosed with anti-NMDAR encephalitis; this antibody was found to be positive in both serum and cerebrospinal fluid (CBA, IIFT, EUROIMMUN AG, Luebeck, Germany). Other causes of encephalitis were rationally excluded. During his hospital stay, he developed symptoms and signs compatible with catatonia. He was treated with high-dose methylprednisolone pulse therapy and therapeutic plasma exchange. Although he comparatively improved, days after finishing his fifth session of therapeutic plasma exchange, he developed a brief episode of opisthotonus (arc de cercle) ([Figure]), which resolved without any treatment. He had never had similar episodes in the past. This movement disorder is infrequently seen in contemporary clinical practice. In the 19th century, hysteria was one of the major differential diagnoses of episodic opisthotonus.[1]
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Publication History
Received: 02 January 2018
Accepted: 17 March 2018
Article published online:
25 August 2023
© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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