{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T06:25:18Z","timestamp":1787034318983,"version":"build-2736575974"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>Anti\u2013metabotropic glutamate receptor 1 (mGluR1) encephalitis is a rare form of autoimmune encephalitis that typically presents with cerebellar dysfunction. Predominant brainstem involvement has seldom been reported. We report an 87-year-old man who presented with a subacute onset of fever, dysarthria, limb\u00a0weakness, and altered mental status. Comprehensive diagnostic evaluation revealed anti-mGluR1 antibodies in both serum and cerebrospinal fluid using a cell-based assay, while cerebrospinal fluid next-generation sequencing (NGS) was negative for infectious pathogens. Brain MRI demonstrated extensive T2-weighted and fluid-attenuated inversion recovery (T2\/FLAIR) hyperintensity involving the midbrain, pons, and medulla, without diffusion restriction. These findings support the possibility that anti-mGluR1 encephalitis may, in rare instances, present with predominant brainstem involvement. Testing for anti-mGluR1 antibodies may be\u00a0considered in patients with otherwise unexplained subacute inflammatory brainstem syndromes.<\/jats:p>","DOI":"10.3389\/fimmu.2026.1831181","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:36:56Z","timestamp":1787031416000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Rare brainstem involvement in anti-metabotropic glutamate receptor 1 encephalitis"],"prefix":"10.3389","volume":"17","author":[{"given":"Meijiao","family":"Hu","sequence":"first","affiliation":[{"name":"Department of Neurology, People's Hospital of Xiangxi Tujia and Miao Autonomous Prefecture\/The First Affiliated Hospital of Jishou University","place":["Jishou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heng","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Radiology, People's Hospital of Xiangxi Tujia and Miao Autonomous Prefecture\/The First Affiliated Hospital of Jishou University","place":["Jishou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Yi","sequence":"additional","affiliation":[{"name":"Department of Neurology, People's Hospital of Xiangxi Tujia and Miao Autonomous Prefecture\/The First Affiliated Hospital of Jishou University","place":["Jishou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1002\/cne.903220110","article-title":"Distribution of the mRNA for a metabotropic glutamate receptor (mGluR1) in the central nervous system: an in situ hybridization study in adult and developing rat","volume":"322","author":"Shigemoto","year":"1992","journal-title":"J Comp Neurol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1177\/1756286419847418","article-title":"Autoimmune encephalitis associated with antibodies against the metabotropic glutamate receptor type 1: case report and review of the literature","volume":"12","author":"Christ","year":"2019","journal-title":"Ther Adv Neurol Disord"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2023.1142160","article-title":"Anti-mGluR1 encephalitis: Case illustration and systematic review","volume":"14","author":"Khojah","year":"2023","journal-title":"Front Neurol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000002476","article-title":"Metabotropic glutamate receptor type 1 autoimmunity: Clinical features and treatment outcomes","volume":"86","author":"Lopez-Chiriboga","year":"2016","journal-title":"Neurology"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000010854","article-title":"Clinical features, prognostic factors, and antibody effects in anti-mGluR1 encephalitis","volume":"95","author":"Spatola","year":"2020","journal-title":"Neurology"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-024-12189-4","article-title":"Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS): contemporary advances and current controversies","volume":"271","author":"Li","year":"2024","journal-title":"J Neurol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2023-258067","article-title":"Clinicoradiological features of probable chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) syndrome","volume":"17","author":"John","year":"2024","journal-title":"BMJ Case Rep"},{"key":"B8","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1186\/s13256-025-05402-z","article-title":"Probable chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids syndrome: management with corticosteroids and intravenous immunoglobulin-a case report","volume":"19","author":"Encarnaci\u00f3n","year":"2025","journal-title":"J Med Case Rep"},{"key":"B9","doi-asserted-by":"publisher","first-page":"iv1","DOI":"10.1093\/neuonc\/noaa200","article-title":"CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2013-2017","volume":"22","author":"Ostrom","year":"2020","journal-title":"Neuro-Oncol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.3390\/medsci13040233","article-title":"Incidence and survival of IDH-wildtype glioblastoma and IDH-mutant astrocytoma by treatment and sex: A regional study in Spain (2011-2021)","volume":"13","author":"Encarnaci\u00f3n","year":"2025","journal-title":"Med Sci"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.3390\/tomography9040122","article-title":"The role of advanced MRI sequences in the diagnosis and follow-up of adult brainstem gliomas: A neuroradiological review","volume":"9","author":"Guarnera","year":"2023","journal-title":"Tomography"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.0023","article-title":"Glioblastoma and other primary brain Malignancies in adults. A review","volume":"329","author":"Schaff","year":"2023","journal-title":"JAMA"},{"key":"B13","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1038\/s41572-023-00439-0","article-title":"Primary central nervous system lymphoma","volume":"9","author":"Ferreri","year":"2023","journal-title":"Nat Rev Dis Primer"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200001063420104","article-title":"Paraneoplastic cerebellar ataxia due to autoantibodies against a glutamate receptor","volume":"342","author":"Sillevis Smitt","year":"2000","journal-title":"N Engl J Med"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jneuroim.2013.07.015","article-title":"Cerebellar degeneration associated with mGluR1 autoantibodies as a paraneoplastic manifestation of prostate adenocarcinoma","volume":"263","author":"Iorio","year":"2013","journal-title":"J Neuroimmunol"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1002\/mdc3.12841","article-title":"Successful management of anti-mGluR1 encephalitis with immunosuppressive treatment: dengue virus as a trigger","volume":"6","author":"Chaumont","year":"2019","journal-title":"Mov Disord Clin Pract"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.3389\/fncir.2020.599600","article-title":"Neuromodulation by mGluRs in sound localization circuits in the auditory brainstem","volume":"14","author":"Goel","year":"2020","journal-title":"Front Neural Circuits"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.3390\/brainsci12091130","article-title":"Autoimmune encephalitis: a physician\u2019s guide to the clinical spectrum diagnosis and management","volume":"12","author":"Patel","year":"2022","journal-title":"Brain Sci"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2025.109229","article-title":"Clinical characteristics, treatment, and outcomes in anti-metabotropic glutamate receptor-1 encephalitis: a systematic review","volume":"259","author":"Li","year":"2025","journal-title":"Clin Neurol Neurosurg"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1831181\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:36:59Z","timestamp":1787031419000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1831181\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,18]]},"references-count":19,"alternative-id":["10.3389\/fimmu.2026.1831181"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2026.1831181","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,18]]},"article-number":"1831181"}}