Investigators at University of Toronto, Canada, report detection of atypical (dysplastic) neuronal elements in 4 of 5 teratomas resected from cases with NMDAR encephalitis but not in 39 controls. These atypical neurons resembled gangliogliomas (n = 3) or ganglioneuroblastoma (n = 1). Abnormal neuroglial elements were closely related to immune infiltrates resected from 4 of 4 cases. Abnormal neurons within teratomas distinguish cases with NMDAR encephalitis from controls and may promote the development of autoimmunity. [1]

COMMENTARY. The authors propose that pathological examination of teratomas removed from patients with NMDAR encephalitis should first focus on areas containing CNS tissue and second on neurons closely approximated by inflammatory infiltrates. The colocalization of dysplastic CNS neurons and inflammatory infiltrates support an autoimmune cause for the clinical encephalitic presentation [1].

Broca's aphasia: a new phenotype of anti NMDAR encephalitis

Investigators at Le Kremlin-Bicetre and centers in Paris, France, report a novel case of anti NMDAR encephalitis in a 4-year-old girl who presented with partial seizures that evolved to sudden and isolated Broca's aphasia and subsequently resolved. Anti NMDAR antibodies were positive in CSF and serum [2].