Glycine Receptor Antibody-mediated Autoimmune Encephalitis: A Case Report

Background: Glycine receptor (GlyR) serves a significant inhibitory function within the neurological system. It may be targeted by autoantibodies which might lead to autoimmune synaptic encephalitis (AE). It can also be associated with other autoimmune diseases, thereby adding complexity to its clinical manifestations and treatment approaches. In this case we present a vegetative condition of a man with GlyR antibody mediated AE.

Case presentation: A 38-year-old previously healthy male, experienced muscular spasms, olfactory and auditory hallucinations, as well as sleep disturbances. He was admitted to the hospital due to his right-sided mouth deviation and severe myoclonic jerks. Subsequently, he suffered a cardio-respiratory failure, leading to a coma. GlyR antibodies were then identified in his serum confirming a diagnosis of anti-GlyR encephalitis. Additionally, his symptoms led to a concurrent diagnosis of progressive encephalomyelitis with rigidity and myoclonus (PERM). He was administered steroids, immunoglobin therapy, and plasma exchange therapy. His brain MRI showed severe atrophy. After a period of follow-up, the patient remained in a vegetative state, awake but lacking awareness of his surroundings.

Conclusion: The incidence of GlyR antibody-associated encephalitis is low. The diverse array of symptoms, resulted in a delay in diagnosis and subsequent treatment in our patient’s case, consequently leading to unfortunate complications.