Tags

Type your tag names separated by a space and hit enter

Anti-N-methyl-D-aspartate receptor encephalitis: a common cause of encephalitis in the intensive care unit.
Neurol Sci. 2016 Dec; 37(12):1993-1998.NS

Abstract

Anti-N-methyl-D-aspartate receptor encephalitis (anti-NMDAR encephalitis) is the most common type of immune-mediated encephalitis. This study aimed to assess the incidence and mortality of anti-NMDAR encephalitis in intensive care unit (ICU) to evaluate the clinical manifestations, laboratory findings, managements and outcomes, and to compare these characteristics with patients with non-anti-NMDAR encephalitis admitted to ICU. Patients admitted to the neurological ICU with suspected encephalitis were included between January 1, 2012 and July 31, 2015. Cerebrospinal fluid (CSF) of enrolled patients was screened for anti-NMDAR antibodies using a cell-based assay. 72 critically ill patients with encephalitis of uncertain etiology were investigated, and 16 patients were positive for anti-NMDAR antibodies in CSF. Compared to patients with non-anti-NMDAR encephalitis, patients with anti-NMDAR encephalitis were younger, more likely to present with the psychiatric symptoms, dyskinesia, and autonomic dysfunction, and had longer ICU stays. The abnormal movements were so difficult to control that complicated the management. The outcome was favorable in ten patients 1 year after the disease onset, and the mortality was as high as 25 % overall. The incidence of anti-NMDAR encephalitis is high among critically ill patients with encephalitis of uncertain etiology. Controlling dyskinesia proved to be a challenge. Persistent dysautonomias were additional difficult to manage confounders. Same points being highlighted in this study may aid clinicians in the management of patients with anti-NMDAR encephalitis in intensive care practice.

Authors+Show Affiliations

Department of Neurology, West China Hospital, Sichuan University, 37# Guoxuexiang, Chengdu, 610041, Sichuan, China.Department of Neurology, West China Hospital, Sichuan University, 37# Guoxuexiang, Chengdu, 610041, Sichuan, China.Neurological Intensive Care Unit, West China Hospital, Sichuan University, Chengdu, Sichuan, China.Neurological Intensive Care Unit, West China Hospital, Sichuan University, Chengdu, Sichuan, China.Department of Neurology, West China Hospital, Sichuan University, 37# Guoxuexiang, Chengdu, 610041, Sichuan, China. zhoudong66@yahoo.de.Department of Neurology, West China Hospital, Sichuan University, 37# Guoxuexiang, Chengdu, 610041, Sichuan, China. 441607140@qq.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27620725

Citation

Chen, Xueping, et al. "Anti-N-methyl-D-aspartate Receptor Encephalitis: a Common Cause of Encephalitis in the Intensive Care Unit." Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, vol. 37, no. 12, 2016, pp. 1993-1998.
Chen X, Li JM, Liu F, et al. Anti-N-methyl-D-aspartate receptor encephalitis: a common cause of encephalitis in the intensive care unit. Neurol Sci. 2016;37(12):1993-1998.
Chen, X., Li, J. M., Liu, F., Wang, Q., Zhou, D., & Lai, X. (2016). Anti-N-methyl-D-aspartate receptor encephalitis: a common cause of encephalitis in the intensive care unit. Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 37(12), 1993-1998.
Chen X, et al. Anti-N-methyl-D-aspartate Receptor Encephalitis: a Common Cause of Encephalitis in the Intensive Care Unit. Neurol Sci. 2016;37(12):1993-1998. PubMed PMID: 27620725.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Anti-N-methyl-D-aspartate receptor encephalitis: a common cause of encephalitis in the intensive care unit. AU - Chen,Xueping, AU - Li,Jin-Mei, AU - Liu,Fan, AU - Wang,Qiong, AU - Zhou,Dong, AU - Lai,Xiaohui, Y1 - 2016/09/12/ PY - 2016/07/10/received PY - 2016/08/29/accepted PY - 2016/9/14/pubmed PY - 2017/2/2/medline PY - 2016/9/14/entrez KW - Anti-N-methyl-D-aspartate receptor encephalitis KW - Clinical manifestations KW - Incidence KW - Intensive care unit KW - Mortality SP - 1993 EP - 1998 JF - Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology JO - Neurol Sci VL - 37 IS - 12 N2 - Anti-N-methyl-D-aspartate receptor encephalitis (anti-NMDAR encephalitis) is the most common type of immune-mediated encephalitis. This study aimed to assess the incidence and mortality of anti-NMDAR encephalitis in intensive care unit (ICU) to evaluate the clinical manifestations, laboratory findings, managements and outcomes, and to compare these characteristics with patients with non-anti-NMDAR encephalitis admitted to ICU. Patients admitted to the neurological ICU with suspected encephalitis were included between January 1, 2012 and July 31, 2015. Cerebrospinal fluid (CSF) of enrolled patients was screened for anti-NMDAR antibodies using a cell-based assay. 72 critically ill patients with encephalitis of uncertain etiology were investigated, and 16 patients were positive for anti-NMDAR antibodies in CSF. Compared to patients with non-anti-NMDAR encephalitis, patients with anti-NMDAR encephalitis were younger, more likely to present with the psychiatric symptoms, dyskinesia, and autonomic dysfunction, and had longer ICU stays. The abnormal movements were so difficult to control that complicated the management. The outcome was favorable in ten patients 1 year after the disease onset, and the mortality was as high as 25 % overall. The incidence of anti-NMDAR encephalitis is high among critically ill patients with encephalitis of uncertain etiology. Controlling dyskinesia proved to be a challenge. Persistent dysautonomias were additional difficult to manage confounders. Same points being highlighted in this study may aid clinicians in the management of patients with anti-NMDAR encephalitis in intensive care practice. SN - 1590-3478 UR - https://www.unboundmedicine.com/medline/citation/27620725/Anti_N_methyl_D_aspartate_receptor_encephalitis:_a_common_cause_of_encephalitis_in_the_intensive_care_unit_ L2 - https://link.springer.com/10.1007/s10072-016-2702-y DB - PRIME DP - Unbound Medicine ER -