Meenakshi Mission Hospital and Research Centre (MMHRC), a leading multispecialty hospital in South Tamil Nadu, successfully treated a 69-year-old male who was diagnosed with rare Atypical autoimmune Parkinsonism with encephalitis.
The patient with a history of diabetes, kidney disease, coronary artery disease with a previous angioplasty, and an enlarged prostate, sought medical help at Meenakshi Mission Hospital & Research Centre. He was experiencing a range of puzzling symptoms, including difficulties in brain function, involuntary trembling, sudden muscle jerks, problems with walking and slowed movements for 3 to 4 months.
Initially treated elsewhere and declared untreatable parkinsonism, his condition continued to deteriorate, compelling him to turn to the expertise of Meenakshi Mission Hospital and Research Centre. Upon admission, a collaborative team of medical experts led by Dr. S. Narendiran, Neurologist and Dr. T. C. Vijay Anand, Senior Consultant & Head of the Department of Neurology at MMHRC assumed responsibility for his care.
Dr. S. Narendiran, Consultant Neurologist explained the nature of the condition, stating, "Parkinsonism is a group of neurodegenerative disorders which present with slowness of physical and mental activities, tremulousness, falls. They are usually progressive managed only with medications without a definite cure. However there are certain neurological disorders which present in a similar way but progressing very rapidly. They belong to a separate group of autoimmune encephalitis and parkinsonism group. Some are already described with the presence of detectable antibodies in their blood. Our patient presented with a distinct set of previously undescribed symtpoms, clinical, imaging and PET features. We have also detected a new antibody which was previously undescribed helping us in curing this patient”
Dr. T. C. Vijay Anand, Senior Consultant & HOD - Department of Neurology further explained, "Upon admission, the patient reported symptoms such as nausea, generalised tremors, and fever. Comprehensive medical tests revealed low levels of sodium in the bloodstream, a condition known as hyponatremia. This was linked to an imbalance in a hormone called antidiuretic hormone, causing the body to retain water instead of excreting it as usual. This imbalance disrupts the body's electrolyte balance, especially sodium levels. Additionally, he displayed anemia, which is a shortage of red blood cells. While brain imaging appeared normal, further examination of cerebrospinal fluid revealed an increase in white blood cells and elevated protein levels. These findings prompted considerations of various potential diagnoses, including paraneoplastic encephalitis, and autoimmune encephalitis."
To establish a definite diagnosis, an intricate diagnostic process was initiated. Advanced imaging through PET CT scans revealed unusual metabolic activity in specific brain regions, indicating the possibility of autoimmune encephalitis. A team of medical experts designed a comprehensive treatment strategy that included steroids, intravenous immunoglobulins (IVIG), plasmapheresis and Inj. Rituximab. This carefully planned approach led to significant improvement in the patient's condition.
Dr. S. Narendiran concluded, "This case underscores the significance of vigilance, particularly in managing intricate and rare medical conditions. Our unwavering commitment to evidence-based medicine and patient-centric care played a pivotal role in achieving a positive outcome in this intricate case."
Dr. B Kannan, Medical Administrator at MMHRC, emphasised, "The successful management of this complex case underscores the holistic commitment of Meenakshi Mission Hospital and Research Centre to providing exemplary healthcare. Our multidisciplinary approach, driven by leading specialists in neurology and administration, is a testament to our dedication to patient well-being and medical advancement."
Expressing his gratitude, the patient shared, "I am profoundly grateful to the medical team at Meenakshi Mission Hospital for their resolute dedication to diagnosing and addressing my condition. Their expertise and unwavering commitment have brought about a transformative change in my life."