Atypical anti-NMDA receptor encephalitis associated with varicella zoster virus infection

Case report: Varicella associated neuropsychiatric syndrome (VANS) in two pediatric cases

“…It is feasible that antigenic similarities noted between VZV, and the brain results in cross-reactivity, culminating in a post-infectious psychiatric syndrome with childhood VZV infections. There are documented cases of auto-reactive anti-NMDA receptor antibody production and consequent NMDA receptor encephalitis following VZV infection all of which meet the Cellucci criteria for AE ( Fatma et al, 2022 ; Schäbitz et al, 2014 ). In the cases reported by Schäbitz et al and Fatma et al both patients demonstrated significant improvement to combined treatment with an antiviral and immunomodulatory IV steroids, with minimal symptoms persisting at follow up, drawing similarities to the two cases presented here ( Fatma et al, 2022 ).…”

“…There are documented cases of auto-reactive anti-NMDA receptor antibody production and consequent NMDA receptor encephalitis following VZV infection all of which meet the Cellucci criteria for AE ( Fatma et al, 2022 ; Schäbitz et al, 2014 ). In the cases reported by Schäbitz et al and Fatma et al both patients demonstrated significant improvement to combined treatment with an antiviral and immunomodulatory IV steroids, with minimal symptoms persisting at follow up, drawing similarities to the two cases presented here ( Fatma et al, 2022 ). In another report by Prakash et al, a 50 year old woman developed a complex neuro-symptom onset including breath holding spells, her CSF PCR was positive for VZV and anti-NMDA receptor antibody, meeting the Cellucci criteria for AE ( Prakash et al, 2019 ).…”