{
  "abstract": "Background: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is the most common autoimmune encephalitis. Neuroimaging findings are frequently normal or nonspecific, and predominant cortical involvement at disease onset is uncommon in anti-NMDAR encephalitis. Overlap with myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) has been increasingly recognized; therefore, the value of individual reports lies in defining their longitudinal phenotypic evolution and diagnostic limitations.\n\nCase presentation: We report a 28-year-old woman with relapsing anti-NMDAR encephalitis followed for nearly seven years across three episodes (the index attack and two relapses). The initial presentation in 2018 was typical anti-NMDAR encephalitis, with positive cerebrospinal fluid (CSF) anti-NMDAR antibodies and complete clinical remission after the first episode. The 2022 relapse manifested as focal cortical encephalitis with progressive unilateral cortical swelling, sulcal enhancement, and seizures; MOG-IgG was not tested. In 2025, she developed recurrent headache, intracranial hypertension, and extensive unilateral cortical involvement, with later detected serum MOG-IgG at 1:32. CSF anti-NMDAR and MOG-IgG were not tested at this admission. The episode was therefore adjudicated as MOG-IgG-positive cortical encephalitis within a longitudinal anti-NMDAR/MOGAD overlap course rather than a proven simultaneous dual-antibody relapse. Oral methylprednisolone was followed by clinical and radiological improvement.\n\nConclusions: Across nearly seven years, this case documents phenotypic evolution from CSF-confirmed anti-NMDAR encephalitis to recurrent unilateral cortical encephalitis and later serum MOG-IgG detection. A changing cortical phenotype should prompt renewed antibody assessment at each recurrence rather than reliance on the index antibody profile. Because MOG-IgG was not tested in earlier episodes and CSF anti-NMDAR was not tested in 2025, the timing and mechanistic contribution of each antibody cannot be determined.\n\nSupplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12883-026-05217-5.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Neurology, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Diseases, Tianjin, China"
  ],
  "article_type": "case report",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Yixiu Lu"
    },
    {
      "affs": [
        0
      ],
      "name": "Zhihong Zhao"
    },
    {
      "affs": [
        0
      ],
      "name": "Ziwei Song"
    },
    {
      "affs": [
        0
      ],
      "name": "Zikai Xin"
    },
    {
      "affs": [
        0
      ],
      "name": "Baiwei Liu"
    },
    {
      "affs": [
        0
      ],
      "name": "Zilong Zhu"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/ccpdx9xy79pkd.bib",
  "cited_by": 0,
  "doi": "10.1186/s12883-026-05217-5",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13741521/",
  "id": "ccpdx9xy79pkd",
  "issns": [
    "1471-2377"
  ],
  "landing_url": "https://doi.org/10.1186/s12883-026-05217-5",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Case Report"
    ],
    [
      "openalex",
      "2728|Autoimmune Neurological Disorders and Treatments"
    ]
  ],
  "openalex": "W7202182292",
  "pdf_url": null,
  "pmcid": "PMC13741521",
  "pmid": "42995546",
  "published": "2026-08-11",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/ccpdx9xy79pkd.ris",
  "sources": [
    {
      "first_seen": "2026-11-10T12:22:34Z",
      "native_id": "PMC13741521",
      "source": "pmc",
      "url": "https://doi.org/10.1186/s12883-026-05217-5"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2728|Autoimmune Neurological Disorders and Treatments",
      "subfield": "neurology"
    }
  ],
  "title": "Relapsing Anti-NMDAR encephalitis with later detected MOG-IgG-Positive cortical encephalitis: a case report",
  "title_text": "Relapsing Anti-NMDAR encephalitis with later detected MOG-IgG-Positive cortical encephalitis: a case report",
  "type": "peer-reviewed",
  "updated_at": "2026-11-10T12:22:34Z",
  "url": "https://research.draconitic.com/paper/ccpdx9xy79pkd",
  "venue": "BMC Neurology",
  "versions": []
}