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Extreme delta brush in a patient with anti-NMDAR encephalitis.
Epileptic Disord. 2013 Dec; 15(4):461-4.ED

Abstract

Anti-N-methyl-D-aspartate receptor encephalitis is a severe, potentially treatable, disorder and prognosis depends on early recognition and prompt immunotherapy. We report a case of anti-N-methyl-D-aspartate receptor encephalitis with atypical age and gender, and a characteristic electroencephalographic pattern that supported the diagnosis. A 66-year-old male presented with psychiatric disturbances and focal seizures with alteration of consciousness, and progressed to a state of akinetic mutism. Auxiliary tests were negative or non-specific for anti-NMDAR encephalitis. Electroencephalographic monitoring revealed a unique pattern; the extreme delta brush. The patient improved with immunotherapy and was asymptomatic at six months of follow-up. Ancillary testing was positive for anti-N-methyl-D-aspartate receptor antibodies. Extreme delta brush is a recently described electroencephalographic pattern presenting in only one third of patients with anti-N-methyl-D-aspartate receptor encephalitis. The identification of this pattern, as in our case, may guide early diagnosis and treatment of anti-N-methyl-D-aspartate receptor encephalitis.

Authors+Show Affiliations

Epilepsy Unit, Hospital Universitario Clinico San Carlos.Hospital Universitario Clinico San Carlos, Madrid, Spain, Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.Epilepsy Unit, Hospital Universitario Clinico San Carlos.Hospital Universitario Clinico San Carlos, Madrid, Spain.Hospital Universitario Clinico San Carlos, Madrid, Spain.Epilepsy Unit, Hospital Universitario Clinico San Carlos.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

24317133

Citation

Di Capua, Daniela, et al. "Extreme Delta Brush in a Patient With anti-NMDAR Encephalitis." Epileptic Disorders : International Epilepsy Journal With Videotape, vol. 15, no. 4, 2013, pp. 461-4.
Di Capua D, García-Ptacek S, García-García ME, et al. Extreme delta brush in a patient with anti-NMDAR encephalitis. Epileptic Disord. 2013;15(4):461-4.
Di Capua, D., García-Ptacek, S., García-García, M. E., Abarrategui, B., Porta-Etessam, J., & García-Morales, I. (2013). Extreme delta brush in a patient with anti-NMDAR encephalitis. Epileptic Disorders : International Epilepsy Journal With Videotape, 15(4), 461-4. https://doi.org/10.1684/epd.2013.0622
Di Capua D, et al. Extreme Delta Brush in a Patient With anti-NMDAR Encephalitis. Epileptic Disord. 2013;15(4):461-4. PubMed PMID: 24317133.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Extreme delta brush in a patient with anti-NMDAR encephalitis. AU - Di Capua,Daniela, AU - García-Ptacek,Sara, AU - García-García,Maria Eugenia, AU - Abarrategui,Belen, AU - Porta-Etessam,Jesús, AU - García-Morales,Irene, PY - 2013/12/10/entrez PY - 2013/12/10/pubmed PY - 2014/4/16/medline KW - VEEG KW - anti-NMDAR encephalitis KW - autoimmune encephalitis KW - extreme delta brush SP - 461 EP - 4 JF - Epileptic disorders : international epilepsy journal with videotape JO - Epileptic Disord VL - 15 IS - 4 N2 - Anti-N-methyl-D-aspartate receptor encephalitis is a severe, potentially treatable, disorder and prognosis depends on early recognition and prompt immunotherapy. We report a case of anti-N-methyl-D-aspartate receptor encephalitis with atypical age and gender, and a characteristic electroencephalographic pattern that supported the diagnosis. A 66-year-old male presented with psychiatric disturbances and focal seizures with alteration of consciousness, and progressed to a state of akinetic mutism. Auxiliary tests were negative or non-specific for anti-NMDAR encephalitis. Electroencephalographic monitoring revealed a unique pattern; the extreme delta brush. The patient improved with immunotherapy and was asymptomatic at six months of follow-up. Ancillary testing was positive for anti-N-methyl-D-aspartate receptor antibodies. Extreme delta brush is a recently described electroencephalographic pattern presenting in only one third of patients with anti-N-methyl-D-aspartate receptor encephalitis. The identification of this pattern, as in our case, may guide early diagnosis and treatment of anti-N-methyl-D-aspartate receptor encephalitis. SN - 1294-9361 UR - https://www.unboundmedicine.com/medline/citation/24317133/Extreme_delta_brush_in_a_patient_with_anti_NMDAR_encephalitis_ L2 - http://www.jle.com/medline.md?issn=1294-9361&vol=15&iss=4&page=461 DB - PRIME DP - Unbound Medicine ER -