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Refractory status epilepticus caused by anti-NMDA receptor encephalitis that markedly improved following combination therapy with rituximab and cyclophosphamide.
Intern Med. 2015; 54(2):209-13.IM

Abstract

We herein describe the case of a 48-year-old woman who presented with nonconvulsive status epilepticus refractory to antiepileptic drugs caused by anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis without any tumors. She developed nausea and psychiatric symptoms, followed by fever and an acute progressive disturbance of consciousness. On admission to our hospital, she presented with involuntary orofacial movements and central hypoventilation, and an electroencephalogram showed a generalized slow activity consistent with nonconvulsive status epilepticus. The patient's drug-resistant status epilepticus markedly improved following second-line immunotherapy with rituximab and cyclophosphamide. Physicians should consider the early initiation of second-line therapy in certain cases of anti-NMDAR encephalitis.

Authors+Show Affiliations

Department of Neurology and Anti-aging Medicine, National Defense Medical College, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

25743014

Citation

Kadoya, Masato, et al. "Refractory Status Epilepticus Caused By anti-NMDA Receptor Encephalitis That Markedly Improved Following Combination Therapy With Rituximab and Cyclophosphamide." Internal Medicine (Tokyo, Japan), vol. 54, no. 2, 2015, pp. 209-13.
Kadoya M, Onoue H, Kadoya A, et al. Refractory status epilepticus caused by anti-NMDA receptor encephalitis that markedly improved following combination therapy with rituximab and cyclophosphamide. Intern Med. 2015;54(2):209-13.
Kadoya, M., Onoue, H., Kadoya, A., Ikewaki, K., & Kaida, K. (2015). Refractory status epilepticus caused by anti-NMDA receptor encephalitis that markedly improved following combination therapy with rituximab and cyclophosphamide. Internal Medicine (Tokyo, Japan), 54(2), 209-13. https://doi.org/10.2169/internalmedicine.54.2047
Kadoya M, et al. Refractory Status Epilepticus Caused By anti-NMDA Receptor Encephalitis That Markedly Improved Following Combination Therapy With Rituximab and Cyclophosphamide. Intern Med. 2015;54(2):209-13. PubMed PMID: 25743014.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Refractory status epilepticus caused by anti-NMDA receptor encephalitis that markedly improved following combination therapy with rituximab and cyclophosphamide. AU - Kadoya,Masato, AU - Onoue,Hiroyuki, AU - Kadoya,Akiko, AU - Ikewaki,Katsunori, AU - Kaida,Kenichi, Y1 - 2015/01/15/ PY - 2015/3/7/entrez PY - 2015/3/7/pubmed PY - 2015/5/27/medline SP - 209 EP - 13 JF - Internal medicine (Tokyo, Japan) JO - Intern. Med. VL - 54 IS - 2 N2 - We herein describe the case of a 48-year-old woman who presented with nonconvulsive status epilepticus refractory to antiepileptic drugs caused by anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis without any tumors. She developed nausea and psychiatric symptoms, followed by fever and an acute progressive disturbance of consciousness. On admission to our hospital, she presented with involuntary orofacial movements and central hypoventilation, and an electroencephalogram showed a generalized slow activity consistent with nonconvulsive status epilepticus. The patient's drug-resistant status epilepticus markedly improved following second-line immunotherapy with rituximab and cyclophosphamide. Physicians should consider the early initiation of second-line therapy in certain cases of anti-NMDAR encephalitis. SN - 1349-7235 UR - https://www.unboundmedicine.com/medline/citation/25743014/Refractory_status_epilepticus_caused_by_anti_NMDA_receptor_encephalitis_that_markedly_improved_following_combination_therapy_with_rituximab_and_cyclophosphamide_ L2 - https://dx.doi.org/10.2169/internalmedicine.54.2047 DB - PRIME DP - Unbound Medicine ER -