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Auto-immune anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis: three case reports.
Paediatr Int Child Health. 2017 Aug; 37(3):222-226.PI

Abstract

Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a recently identified auto-immune disorder characterised by severe memory deficit, a decreased level of consciousness, seizures, autonomic dysfunction and movement disorders. Three girls with the disorder are reported; they were aged 4 years, 5 years and 10 months. The 10-month-old infant who is one of the youngest patients reported with anti-NMDAR encephalitis worldwide, had MRI features suggestive of herpes simplex encephalitis (known to trigger anti-NMDAR encephalitis), but CSF PCR for herpes simplex was negative. All the patients presented with seizures, behavioural change, regression of speech, dystonia and choreo-athetosis. Anti-NMDAR antibodies were detected in all patients' sera and cerebrospinal fluid (CSF). Intravenous immunoglobulin, corticosteroids and rituximab were administered at different intervals. Cases 1 and 2 made a full recovery, but case 3 has mild motor and speech delay. Patients who present with encephalopathy, seizures and movement disorders should be tested for anti-NMDAR antibodies in serum and CSF in addition to being screened for herpes simplex encephalitis.

Authors+Show Affiliations

a Division of Pediatric Neurology.b Pediatric Rheumatology, Department of Pediatrics.a Division of Pediatric Neurology.a Division of Pediatric Neurology.a Division of Pediatric Neurology.a Division of Pediatric Neurology.c Division of Neuroradiology, Department of Radiology, College of Medicine and King Khalid University Hospital , King Saud University , Riyadh , Saudi Arabia.a Division of Pediatric Neurology.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

27329512

Citation

Bashiri, Fahad A., et al. "Auto-immune anti-N-methyl-D-aspartate Receptor (anti-NMDAR) Encephalitis: Three Case Reports." Paediatrics and International Child Health, vol. 37, no. 3, 2017, pp. 222-226.
Bashiri FA, Al-Rasheed AA, Hassan SM, et al. Auto-immune anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis: three case reports. Paediatr Int Child Health. 2017;37(3):222-226.
Bashiri, F. A., Al-Rasheed, A. A., Hassan, S. M., Hamad, M. H. A., El Khashab, H. Y., Kentab, A. Y., AlBadr, F. B., & Salih, M. A. (2017). Auto-immune anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis: three case reports. Paediatrics and International Child Health, 37(3), 222-226. https://doi.org/10.1080/20469047.2016.1191852
Bashiri FA, et al. Auto-immune anti-N-methyl-D-aspartate Receptor (anti-NMDAR) Encephalitis: Three Case Reports. Paediatr Int Child Health. 2017;37(3):222-226. PubMed PMID: 27329512.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Auto-immune anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis: three case reports. AU - Bashiri,Fahad A, AU - Al-Rasheed,Abdulrahman A, AU - Hassan,Saeed M, AU - Hamad,Muddathir H A, AU - El Khashab,Heba Y, AU - Kentab,Amal Y, AU - AlBadr,Fahad B, AU - Salih,Mustafa A, Y1 - 2016/06/22/ PY - 2016/6/23/pubmed PY - 2018/3/9/medline PY - 2016/6/23/entrez KW - Anti-NMDAR encephalitis KW - Auto-antibodies KW - Children KW - Immunomodulation therapy KW - Movement disorder SP - 222 EP - 226 JF - Paediatrics and international child health JO - Paediatr Int Child Health VL - 37 IS - 3 N2 - Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a recently identified auto-immune disorder characterised by severe memory deficit, a decreased level of consciousness, seizures, autonomic dysfunction and movement disorders. Three girls with the disorder are reported; they were aged 4 years, 5 years and 10 months. The 10-month-old infant who is one of the youngest patients reported with anti-NMDAR encephalitis worldwide, had MRI features suggestive of herpes simplex encephalitis (known to trigger anti-NMDAR encephalitis), but CSF PCR for herpes simplex was negative. All the patients presented with seizures, behavioural change, regression of speech, dystonia and choreo-athetosis. Anti-NMDAR antibodies were detected in all patients' sera and cerebrospinal fluid (CSF). Intravenous immunoglobulin, corticosteroids and rituximab were administered at different intervals. Cases 1 and 2 made a full recovery, but case 3 has mild motor and speech delay. Patients who present with encephalopathy, seizures and movement disorders should be tested for anti-NMDAR antibodies in serum and CSF in addition to being screened for herpes simplex encephalitis. SN - 2046-9055 UR - https://www.unboundmedicine.com/medline/citation/27329512/Auto_immune_anti_N_methyl_D_aspartate_receptor__anti_NMDAR__encephalitis:_three_case_reports_ L2 - http://www.tandfonline.com/doi/full/10.1080/20469047.2016.1191852 DB - PRIME DP - Unbound Medicine ER -