{
  "abstract": "AMPA receptors (AMPAR) mediate excitatory neurotransmission in the brain, and rarely can be targeted by autoantibodies to cause encephalitis, often as a paraneoplastic phenomenon. The associated clinical syndrome can feature a wide variety of symptoms, though persisting visual field defects are scarcely reported.We report the case of a previously well 48-year-old gentleman of Kenyan descent who presented with rapidly progressive visual disturbance, global cognitive decline, severe agitation, auditory and visual hallucinations, and marked ataxia. Admission to ICU for intubation and ventilation to facilitate sedation was required to manage extreme behavioural disturbance. MRI showed scattered abnormal FLAIR and DWI signal involving multiple cortical regions, including bilateral occipital lobes. He was subsequently found to have anti-AMPAR antibodies in both his serum and cerebrospinal fluid. He had no evidence of malignancy on extensive testing.Following prolonged treatment with high dose steroids, intravenous immunoglobulin, plasma exchange and rituximab he has had a significant clinical improvement. However, his bilateral visual field constriction remains severe.This case contributes to the clinical understanding of anti-AMPAR encephalitis, its various manifestations and prognosis and highlights the challenges of management.",
  "authors": [
    {
      "affiliations": [
        "Cairns Hospital, Cairns City, QLD, Australia"
      ],
      "name": "Alexandra Henderson"
    },
    {
      "affiliations": [
        "Cairns Hospital, Cairns City, QLD, Australia"
      ],
      "name": "Joseph Mohan"
    },
    {
      "affiliations": [
        "Cairns Hospital, Cairns City, QLD, Australia"
      ],
      "name": "Ian Wilson"
    }
  ],
  "title": "3622 A case report: anti-AMPAR encephalitis complicated by permanent severe visual field constriction",
  "uid": "297cc72a-0135-5044-8f18-6e90e5ff20e0"
}