Anti-NMDA receptor encephalitis following Murray Valley encephalitis: a case report
Bibliographic record
Abstract
Background: Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is an autoimmune condition that is increasingly being recognized as a complication of central nervous system infections. While association with herpes simplex virus encephalitis is well established, the condition has also been reported to occur following Japanese encephalitis virus infection and yellow fever vaccination. Case Summary: Here, we report a case of anti-NMDA receptor encephalitis following infection with Murray Valley encephalitis virus (MVEV), another virus of the family Flaviviridae. Following initial recovery, and 34 days after the onset of illness, our patient developed autonomic instability, orofacial dyskinesia, and decreased level of consciousness. Diagnosis was established with the detection of anti-NMDA receptor antibodies in cerebrospinal fluid. Immunosuppressive therapy with rituximab and corticosteroids resulted in a favorable outcome. Conclusion: This case report raises awareness of post-viral autoimmune encephalitis which should be considered in patients with a biphasic pattern of illness following viral encephalitis or a compatible clinical syndrome. Given the initial diagnosis of Murray Valley encephalitis, clinicians should be alert to the possibility of MVEV as an infectious trigger associated with the development of anti-NMDA receptor encephalitis. We also highlight the challenges inherent in the diagnosis of flavivirus infections, which may require a combination of clinical, epidemiological, and laboratory evidence.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".