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Early electro-clinical features may contribute to diagnosis of the anti-NMDA receptor encephalitis in children.
Clin Neurophysiol. 2013 Dec; 124(12):2354-61.CN

Abstract

OBJECTIVE

To describe initial and follow-up electroencephalographic (EEG) characteristics in anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis.

METHODS

Consecutive polygraphic video-EEG recordings were analyzed in nine pediatric patients with anti-NMDAR encephalitis at the initial stage of the disease and during the intermediate period until motor recovery. EEG characteristics in waking and sleep stages as well as EEG correlates of abnormal movements are described.

RESULTS

In six patients, [corrected] the waking EEG showed preserved background activity and either focal or unilateral hemispheric slowing. These children had more favorable outcome than the three children with diffuse slowing. Unilateral [corrected] abnormal movements contra-lateral to hemispheric or focal slowing were also indicative of milder severity when compared to generalized abnormal movements and diffuse slowing. During non-rapid eye movement (NREM) sleep, a decrease in the expected slow waves and unilateral or diffuse theta-alpha band rhythms were observed in six children, not correlated with the outcome, representing a suggestive EEG pattern of anti-NMDAR encephalitis. [corrected].

CONCLUSIONS

In pediatric patients presenting behavioral disorders and abnormal movements, early EEG patterns may be suggestive of anti-NMDAR encephalitis. Moreover early electro-clinical presentation contributes to outcome prediction.

SIGNIFICANCE

This case series demonstrates that early EEG patterns may be suggestive of anti-NMDAR encephalitis in pediatric patients with behavioral disorders and abnormal movements.

Authors+Show Affiliations

Service de neurologie pédiatrique et maladies métaboliques, hôpital Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France; Service d'explorations fonctionnelles, laboratoire de neurophysiologie clinique, hôpital Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France; INSERM U1016-CNRS8104-Université Paris-Descartes, Faculté de Médecine, Paris, France. Electronic address: cyril.gitiaux@nck.aphp.fr.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23830005

Citation

Gitiaux, Cyril, et al. "Early Electro-clinical Features May Contribute to Diagnosis of the anti-NMDA Receptor Encephalitis in Children." Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology, vol. 124, no. 12, 2013, pp. 2354-61.
Gitiaux C, Simonnet H, Eisermann M, et al. Early electro-clinical features may contribute to diagnosis of the anti-NMDA receptor encephalitis in children. Clin Neurophysiol. 2013;124(12):2354-61.
Gitiaux, C., Simonnet, H., Eisermann, M., Leunen, D., Dulac, O., Nabbout, R., Chevignard, M., Honnorat, J., Gataullina, S., Musset, L., Scalais, E., Gauthier, A., Hully, M., Boddaert, N., Kuchenbuch, M., Desguerre, I., & Kaminska, A. (2013). Early electro-clinical features may contribute to diagnosis of the anti-NMDA receptor encephalitis in children. Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology, 124(12), 2354-61. https://doi.org/10.1016/j.clinph.2013.05.023
Gitiaux C, et al. Early Electro-clinical Features May Contribute to Diagnosis of the anti-NMDA Receptor Encephalitis in Children. Clin Neurophysiol. 2013;124(12):2354-61. PubMed PMID: 23830005.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Early electro-clinical features may contribute to diagnosis of the anti-NMDA receptor encephalitis in children. AU - Gitiaux,Cyril, AU - Simonnet,Hina, AU - Eisermann,Monika, AU - Leunen,Dorothee, AU - Dulac,Olivier, AU - Nabbout,Rima, AU - Chevignard,Mathilde, AU - Honnorat,Jerôme, AU - Gataullina,Svetlana, AU - Musset,Lucile, AU - Scalais,Emmanuel, AU - Gauthier,Agnès, AU - Hully,Marie, AU - Boddaert,Nathalie, AU - Kuchenbuch,Mathieu, AU - Desguerre,Isabelle, AU - Kaminska,Anna, Y1 - 2013/07/02/ PY - 2013/01/22/received PY - 2013/05/30/revised PY - 2013/05/30/accepted PY - 2013/7/9/entrez PY - 2013/7/9/pubmed PY - 2014/3/13/medline KW - Anti-NMDA receptor encephalitis KW - Child KW - Electroencephalogram KW - Outcome SP - 2354 EP - 61 JF - Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology JO - Clin Neurophysiol VL - 124 IS - 12 N2 - OBJECTIVE: To describe initial and follow-up electroencephalographic (EEG) characteristics in anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis. METHODS: Consecutive polygraphic video-EEG recordings were analyzed in nine pediatric patients with anti-NMDAR encephalitis at the initial stage of the disease and during the intermediate period until motor recovery. EEG characteristics in waking and sleep stages as well as EEG correlates of abnormal movements are described. RESULTS: In six patients, [corrected] the waking EEG showed preserved background activity and either focal or unilateral hemispheric slowing. These children had more favorable outcome than the three children with diffuse slowing. Unilateral [corrected] abnormal movements contra-lateral to hemispheric or focal slowing were also indicative of milder severity when compared to generalized abnormal movements and diffuse slowing. During non-rapid eye movement (NREM) sleep, a decrease in the expected slow waves and unilateral or diffuse theta-alpha band rhythms were observed in six children, not correlated with the outcome, representing a suggestive EEG pattern of anti-NMDAR encephalitis. [corrected]. CONCLUSIONS: In pediatric patients presenting behavioral disorders and abnormal movements, early EEG patterns may be suggestive of anti-NMDAR encephalitis. Moreover early electro-clinical presentation contributes to outcome prediction. SIGNIFICANCE: This case series demonstrates that early EEG patterns may be suggestive of anti-NMDAR encephalitis in pediatric patients with behavioral disorders and abnormal movements. SN - 1872-8952 UR - https://www.unboundmedicine.com/medline/citation/23830005/Early_electro_clinical_features_may_contribute_to_diagnosis_of_the_anti_NMDA_receptor_encephalitis_in_children_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1388-2457(13)00697-4 DB - PRIME DP - Unbound Medicine ER -