Herpes simplex encephalitis (HSE) and anti-N-methyl-D-aspartate
receptor (anti-NMDAR) encephalitis are associated entities. On the
contrary, although both are autoimmune diseases, the association of
neuromyelitis optica spectrum disorder (NMOSD) and anti-NMDAR
encephalitis is not well explained. Herein, we present consecutively
developed post-herpetic anti-NMDAR encephalitis in a patient with
the coexistence of NMOSD and Sjogren syndrome. In our patient
evaluation with MRI and clinical findings, the diagnosis of HSE
after immunosuppressive drug application for NMOSD was made.
Whereupon, HSE triggered NMDAR encephalitis. Many authors
demonstrated the induction of anti-NMDAR encephalitis over herpes
encephalitis with the presence of movement disorders, psychiatric
manifestations, and cognitive dysfunction. In our patient, without
biphasic disease activity; the persistence of symptoms, new MRI findings,
and the positivity of anti-NMDAR antibody confirmed the anti-NMDAR
encephalitis diagnosis. Our patient is a representative case mentioning
the importance of close follow-up of a patient in neuroimmunology.
Keywords: Neuromyelitis optica spectrum disorder, herpes simplex
encephalitis, anti-N-methyl-D-aspartate receptor encephalitis