Extended Clinical Spectrum of Anti-N-Methyl-d-Aspartate Receptor Encephalitis in Children: A Case Series

Pediatric Neurology
Ajay GoenkaMitchell Steinschneider

Abstract

There is a wide spectrum of clinical manifestations in children with anti-N-methyl-d-aspartate (NMDA) receptor antibody encephalitis from two different health care settings. We describe our experience with 13 patients (median age, 7 years; range, 5 months to 19 years) presenting to tertiary referral centers in India and the United States. Initial manifestations were neurological (seizures or movement disorders) in eight patients, and psychiatric (e.g., emotional lability and hallucination) in five patients. Symptoms during the clinical course included seizures in ten patients, movement disorders (dyskinesia and choreiform movements) in 11 patients, and behavioral changes (aggressiveness and insomnia) in ten patients. Concomitant infections (herpes simplex virus 1, tuberculous meningitis, and influenza A) were present in three patients. Analysis of the cerebrospinal fluid in all except two cases preceded by infection (herpes simplex virus encephalitis and tuberculous meningitis) was unremarkable. Treatment included intravenous immunoglobulin/methylprednisolone (11 patients), rituximab (eight patients), plasmapheresis (two patients), and cyclophosphamide (two patients). Six patients recovered completely. Two patients had mild res...Continue Reading

Citations

May 22, 2018·Current Treatment Options in Rheumatology·Cory StinglHeather Van Mater
Sep 19, 2019·BMJ Case Reports·Sara TeixeiraFátima Santos
Jun 25, 2020·Neurology·Helena AriñoJoan Santamaria
Feb 3, 2021·Pediatrics in Review·Claire E FraleyDawn Nolt
Jul 3, 2021·Journal of Clinical Medicine·Giacomo GaroneAlessandro Capuano
Jul 18, 2021·Current Problems in Pediatric and Adolescent Health Care·Ajay GoenkaGogi Kumar

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