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Clinical case of anti-N-methyl-D-aspartate receptor encephalitis in an 8-month-old patient with hyperkinetic movement disorder.
Pediatr Neurol. 2013 May; 48(5):400-2.PN

Abstract

This article describes an 8-month-old boy with the full clinical spectrum anti-N-methyl-d-aspartate receptor encephalitis. He was admitted to the hospital with involuntary orofacial head movements, behavioral changes, and fluctuation in consciousness. His examination showed tongue thrusting, decreased responsiveness, and hypotonia without fever. Analysis of the cerebrospinal fluid revealed increased protein levels (62 mg/dL). The next day he developed oral dyskinesia and choreoathetosis. Video-electroencephalogram polygraphy showed coreo-dystonic movements without electrographic correlation. A putative diagnosis of autoimmune encephalopathy was made, and treatment with intravenous immunoglobulin and methylprednisolone was started, with improvement in the abnormal movements. Antibodies to the N-methyl-d-aspartate receptor were identified in the cerebrospinal fluid and blood. He began receiving immunoglobulin once a month for a year. Two months after the treatment had started, the involuntary movement disappeared and his development has been normal. N-methyl-d-aspartate receptor encephalitis is a recently identified disorder. This is the youngest case reported. Prompt diagnosis and treatment are important to obtain full recovery.

Authors+Show Affiliations

Department of Pediatric Neurology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain. verocantarin@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

23583060

Citation

Cantarín-Extremera, Verónica, et al. "Clinical Case of anti-N-methyl-D-aspartate Receptor Encephalitis in an 8-month-old Patient With Hyperkinetic Movement Disorder." Pediatric Neurology, vol. 48, no. 5, 2013, pp. 400-2.
Cantarín-Extremera V, Duat-Rodríguez A, González-Gutiérrez-Solana L, et al. Clinical case of anti-N-methyl-D-aspartate receptor encephalitis in an 8-month-old patient with hyperkinetic movement disorder. Pediatr Neurol. 2013;48(5):400-2.
Cantarín-Extremera, V., Duat-Rodríguez, A., González-Gutiérrez-Solana, L., López-Marín, L., & Armangue, T. (2013). Clinical case of anti-N-methyl-D-aspartate receptor encephalitis in an 8-month-old patient with hyperkinetic movement disorder. Pediatric Neurology, 48(5), 400-2. https://doi.org/10.1016/j.pediatrneurol.2012.12.032
Cantarín-Extremera V, et al. Clinical Case of anti-N-methyl-D-aspartate Receptor Encephalitis in an 8-month-old Patient With Hyperkinetic Movement Disorder. Pediatr Neurol. 2013;48(5):400-2. PubMed PMID: 23583060.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical case of anti-N-methyl-D-aspartate receptor encephalitis in an 8-month-old patient with hyperkinetic movement disorder. AU - Cantarín-Extremera,Verónica, AU - Duat-Rodríguez,Anna, AU - González-Gutiérrez-Solana,Luis, AU - López-Marín,Laura, AU - Armangue,Thaís, PY - 2012/08/26/received PY - 2012/12/31/accepted PY - 2013/4/16/entrez PY - 2013/4/16/pubmed PY - 2013/10/18/medline SP - 400 EP - 2 JF - Pediatric neurology JO - Pediatr Neurol VL - 48 IS - 5 N2 - This article describes an 8-month-old boy with the full clinical spectrum anti-N-methyl-d-aspartate receptor encephalitis. He was admitted to the hospital with involuntary orofacial head movements, behavioral changes, and fluctuation in consciousness. His examination showed tongue thrusting, decreased responsiveness, and hypotonia without fever. Analysis of the cerebrospinal fluid revealed increased protein levels (62 mg/dL). The next day he developed oral dyskinesia and choreoathetosis. Video-electroencephalogram polygraphy showed coreo-dystonic movements without electrographic correlation. A putative diagnosis of autoimmune encephalopathy was made, and treatment with intravenous immunoglobulin and methylprednisolone was started, with improvement in the abnormal movements. Antibodies to the N-methyl-d-aspartate receptor were identified in the cerebrospinal fluid and blood. He began receiving immunoglobulin once a month for a year. Two months after the treatment had started, the involuntary movement disappeared and his development has been normal. N-methyl-d-aspartate receptor encephalitis is a recently identified disorder. This is the youngest case reported. Prompt diagnosis and treatment are important to obtain full recovery. SN - 1873-5150 UR - https://www.unboundmedicine.com/medline/citation/23583060/Clinical_case_of_anti_N_methyl_D_aspartate_receptor_encephalitis_in_an_8_month_old_patient_with_hyperkinetic_movement_disorder_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0887-8994(13)00011-8 DB - PRIME DP - Unbound Medicine ER -