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Anti-NMDA-receptor antibody encephalitis in infants.
Epilepsy Behav Case Rep. 2015; 4:99-101.EB

Abstract

PURPOSE

Anti-N-methyl-d-aspartate (NMDA) receptor antibody encephalitis is an autoimmune disorder manifesting subacutely with prominent aberrant movements and psychiatric symptoms. The clinical course is one of progressive clinical deterioration that can be halted and often reversed by early diagnosis and treatment. Patterns of presentation and etiology of anti-NMDA-receptor antibody encephalitis are dependent on age and can be challenging to recognize in very young children.

REPORTS

Sequential clinical case observations of anti-NMDA-receptor antibody encephalitis presenting in very young children were examined over a year at a single tertiary pediatric institution. Cerebrospinal fluid confirmed anti-NMDA-receptor antibodies in two cases (a 21-month-old boy and a 29-month-old girl) that demonstrated either bizarre behavioral patterns or status epilepticus both associated with progressive deterioration. Once recognized, the clinical course was arrested and reversed by aggressive treatment with plasma exchange, immunoglobulin, and high dose IV steroids.

CONCLUSION

Infants with anti-NMDA-receptor antibody encephalitis can present with frank seizures or seizure mimics. Regardless, prompt recognition and aggressive treatment of anti-NMDA-receptor antibody encephalitis, while challenging, can quickly arrest deterioration and hasten recovery, thereby, limiting neurological morbidity.

Authors+Show Affiliations

University of Florida & Wolfson Children Hospital, Jacksonville, FL, USA.Nemours Children Health System, Jacksonville, FL, USA; Mayo Clinic, Jacksonville, FL, USA.Nemours Children Health System, Jacksonville, FL, USA; Mayo Clinic, Jacksonville, FL, USA.University of Florida & Wolfson Children Hospital, Jacksonville, FL, USA; Nemours Children Health System, Jacksonville, FL, USA.Nemours Children Health System, Jacksonville, FL, USA.University of Florida & Wolfson Children Hospital, Jacksonville, FL, USA; Nemours Children Health System, Jacksonville, FL, USA; Mayo Clinic, Jacksonville, FL, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26744696

Citation

Matoq, Amr A., et al. "Anti-NMDA-receptor Antibody Encephalitis in Infants." Epilepsy & Behavior Case Reports, vol. 4, 2015, pp. 99-101.
Matoq AA, Rappoport AS, Yang Y, et al. Anti-NMDA-receptor antibody encephalitis in infants. Epilepsy & behavior case reports. 2015;4:99-101.
Matoq, A. A., Rappoport, A. S., Yang, Y., O'Babatunde, J., Bakerywala, R., & Sheth, R. D. (2015). Anti-NMDA-receptor antibody encephalitis in infants. Epilepsy & Behavior Case Reports, 4, 99-101. https://doi.org/10.1016/j.ebcr.2015.07.005
Matoq AA, et al. Anti-NMDA-receptor Antibody Encephalitis in Infants. Epilepsy & behavior case reports. 2015;4:99-101. PubMed PMID: 26744696.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Anti-NMDA-receptor antibody encephalitis in infants. AU - Matoq,Amr A, AU - Rappoport,Adam S, AU - Yang,Yiting, AU - O'Babatunde,Jessica, AU - Bakerywala,Rubina, AU - Sheth,Raj D, Y1 - 2015/11/04/ PY - 2015/07/26/received PY - 2015/07/30/revised PY - 2015/07/31/accepted PY - 2016/1/9/entrez PY - 2016/1/9/pubmed PY - 2016/1/9/medline KW - Anti-NMDA-receptor, anti-N-methyl-d-aspartate-receptor KW - Anti-NMDAR KW - Behavioral outburst KW - CSF, cerebrospinal fluid KW - Child KW - EEG, electroencephalogram KW - Encephalitis KW - Paraneoplastic syndrome KW - Psychosis SP - 99 EP - 101 JF - Epilepsy & behavior case reports VL - 4 N2 - PURPOSE: Anti-N-methyl-d-aspartate (NMDA) receptor antibody encephalitis is an autoimmune disorder manifesting subacutely with prominent aberrant movements and psychiatric symptoms. The clinical course is one of progressive clinical deterioration that can be halted and often reversed by early diagnosis and treatment. Patterns of presentation and etiology of anti-NMDA-receptor antibody encephalitis are dependent on age and can be challenging to recognize in very young children. REPORTS: Sequential clinical case observations of anti-NMDA-receptor antibody encephalitis presenting in very young children were examined over a year at a single tertiary pediatric institution. Cerebrospinal fluid confirmed anti-NMDA-receptor antibodies in two cases (a 21-month-old boy and a 29-month-old girl) that demonstrated either bizarre behavioral patterns or status epilepticus both associated with progressive deterioration. Once recognized, the clinical course was arrested and reversed by aggressive treatment with plasma exchange, immunoglobulin, and high dose IV steroids. CONCLUSION: Infants with anti-NMDA-receptor antibody encephalitis can present with frank seizures or seizure mimics. Regardless, prompt recognition and aggressive treatment of anti-NMDA-receptor antibody encephalitis, while challenging, can quickly arrest deterioration and hasten recovery, thereby, limiting neurological morbidity. SN - 2213-3232 UR - https://www.unboundmedicine.com/medline/citation/26744696/Anti_NMDA_receptor_antibody_encephalitis_in_infants_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2213-3232(15)00034-1 DB - PRIME DP - Unbound Medicine ER -
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