An encephalitis-like syndrome in an adult with methylmalonic acidemia and hyperhomocysteinemia: A case report

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07 Nov 2026 0 comments

RATIONALE: Methylmalonic acidemia with hyperhomocysteinemia may remain unrecognized until adulthood. When fever, altered consciousness, psychiatric symptoms, cerebrospinal fluid (CSF) abnormalities, and electroencephalographic slowing dominate the presentation, infectious or autoimmune encephalitis is often considered first. Glutamic acid decarboxylase 65 antibody positivity may further complicate the diagnostic interpretation.