Y Y Guo, X Y Lü, Y Wu, Y Chen, Q Wei, N Zhou, K Wang, Y H Tian
Objective: To investigated cognitive and cerebral blood flow changes in a cohort of patients with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. Methods: Fifteen patients with confirmed anti-NMDAR encephalitis from the First Affiliated Hospital of Anhui Medical University and the First Affiliated Hospital of University of Science and Technology of China between June 2015 and February 2019 were included in the study. Meanwhile, another 15 healthy subjects were selected as controls. All participants underwent neuropsychological tests for assessment of the clinical symptoms and arterial spin labeling (ASL) of magnetic resonance perfusion imaging scan were employed to evaluate cerebral perfusion...
July 7, 2020: Zhonghua Yi Xue za Zhi [Chinese medical journal]
S M Zhou, H Z Guan, M S Zhao, F J Huang, Y Wei, J Wang, J P Liu, X L Zhao, H T Ren, S Y Fan, B Peng, L Y Qiao
Objective: To study the clinical features, continuous care and prognosis of the patients with severe and refractory anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis after intensive care unit (ICU). Methods: Clinical data of patients with severe and refractory anti-NMDAR encephalitis, who were transferred from ICU to general ward of neurology between December 2015 and October 2019, were retrospectively reviewed and analyzed in the study. Results: Twenty patients (11 females and 9 males) were enrolled in the study...
July 7, 2020: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Virginie Desestret
No abstract text is available yet for this article.
June 2020: Annals of Translational Medicine
Yingxin Wang, Ailiang Miao, Yongwei Shi, Jianqing Ge, Lingling Wang, Chuanyong Yu, Haiyan Xu, Yuanwen Yu, Shuyang Huang, Yihan Li, Xiaoshan Wang
The clinical manifestations of patients with anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis in East China and factors associated with prognosis were analyzed. A retrospective study of 106 patients (58 females; 48 males) with anti-NMDAR encephalitis in East China was carried out from June 2015 to February 2019. Clinical features and factors influencing outcomes were reviewed. Behavioral changes were observed in 74.5% (79/106) of patients, and comprised the initial symptoms in 61.3% (65/106). Seizures were observed in 67% (71/106) of patients, and served as initial symptoms in 31...
July 1, 2020: Scientific Reports
Xi-Yu Li, Zhi-Hong Shi, Ya-Lin Guan, Yong Ji
BACKGROUND: Anti-N-methyl-D-aspartate-receptor (NMDAR) encephalitis is a common type of autoimmune encephalitis characterized by complex clinical signs and variable imaging manifestations. The pathogenesis of the disease is unclear. Syphilis is an infectious disease caused by Treponema pallidum that can invade the nervous and immune systems and cause systemic symptoms. There are few reports of anti-NMDAR encephalitis with syphilis, and the association between them is unknown; both diseases are related to immune system damage...
June 26, 2020: World Journal of Clinical Cases
S Gong, W H Zhang, H T Ren, J W Li, J Zhou, H Cheng, X W Zhuo, C H Ren, T L Han, J L Lyu, C H Ding, F Fang, H Z Guan, X T Ren
Objective: To investigate the clinical features, imaging findings and prognosis of children with overlapping syndrome of myelin oligodendrocyte glycoprotein (MOG) antibody disease and anti-N-methyl-D aspartate receptor (NMDAR) encephalitis (MNOS). Methods: The clinical manifestations, immunological antibodies in blood and cerebrospinal fluid, cranial image, treatment and follow-up of 11 patients diagnosed as MNOS in the Department of Neurology, Beijing Children's Hospital from January 2011 to April 2019 were analyzed retrospectively...
July 2, 2020: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Wei Zeng, Liming Cao, Jinou Zheng, Lu Yu
OBJECTIVE: To analyze the clinical profile and long-term prognosis of relapsing anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. METHOD: This is a retrospective, multicenter, self-controlled study of 10 patients with relapsing anti-NMDAR encephalitis. Relapse was defined as new psychiatric or neurologic syndrome unexplainable by other causes that improved after immunotherapy. RESULTS: The main symptoms at first onset and relapse included psychiatric symptoms, cognitive impairment, speech dysfunction, seizures, consciousness disturbance, movement disorders, central hypoventilation, and autonomic dysfunction...
June 29, 2020: Neurological Sciences
Baojie Wang, Chunjuan Wang, Haitao Ren, Hongzhi Guan, Shougang Guo
Cerebellar ataxia is an atypical presentation of anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis. In patients with anti-NMDAR encephalitis, cerebellar ataxia often develops simultaneously or sequentially with clinical features of demyelinating disorders, paraneoplastic neurologic syndromes, despite unremarkable brain magnetic resonance imagerying (MRI) findings. Herein, we report a patient with anti-NMDAR encephalitis who developed dizziness and gait ataxia as the initial symptoms, simultaneously showing MRI hyperintensities involving the cerebellum, even before manifesting behavioral and cognitive symptoms...
June 17, 2020: Journal of Neuroimmunology
Marc Carceles-Cordon, Francesco Mannara, Esther Aguilar, Aida Castellanos, Jesús Planagumà, Josep Dalmau
OBJECTIVE: To demonstrate that antibodies from patients with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis alter the levels of dopamine 1 receptor (D1R) and dopamine 2 receptor (D2R) and cause psychotic-like features in mice. METHODS: Cultured rat hippocampal neurons were treated with cerebrospinal fluid (CSF) from patients with anti-NMDAR encephalitis or controls, and the effects on clusters of D1R and D2R were quantified. In vivo studies included 71 C57BL/6J mice that were chronically infused with patients' or controls' CSF through ventricular catheters connected to subcutaneous osmotic pumps...
June 25, 2020: Annals of Neurology
Melissa Chavez-Castillo, Matilde Ruiz-Garcia, Patricia Herrera-Mora
Introduction Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is one of the most common autoimmune encephalitides. The frequency of anti-NMDAR encephalitis is known to exceed the frequency of any individual viral encephalitis in young subjects. Epileptic seizures are a cardinal symptom in anti-NMDAR encephalitis; a significant amount of pediatric patients exhibit seizures as the first symptom of the disease, and most of them will develop them during the acute phase. The use of antiepileptic drugs (AEDs) is a cornerstone of the treatment of these patients, but the choice of agent and duration of treatment is currently unknown...
May 20, 2020: Curēus
Helena Ariño, Amaia Muñoz-Lopetegi, Eugenia Martinez-Hernandez, Thaís Armangue, Mireia Rosa-Justicia, Domingo Escudero, Nuria Matos, Francesc Graus, Gisela Sugranyes, Josefina Castro-Fornieles, Albert Compte, Josep Dalmau, Joan Santamaria
OBJECTIVE: To describe the sleep disorders in anti-NMDA receptor encephalitis (anti-NMDARe). METHODS: Patients recovering from anti-NMDARe were invited to participate in a prospective observational single center study including comprehensive clinical, video-polysomnography (V-PSG) sleep assessment and neuropsychological evaluation. Age and sex-matched healthy participants served as controls. RESULTS: Eighteen patients (89% female, median age 26 years, IQR 21-29) and 21 controls (81% female, median age 23 years, IQR 18-26) were included...
June 23, 2020: Neurology
Ryohei Norioka, Satoko Kumada, Shinsuke Tobisawa, Yu Tsuyusaki, Eiji Isozaki
OBJECTIVES: To investigate the clinical characteristics of children and adults with anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis. METHODS: Patients who tested positive for the anti-NMDAR antibody (by a cell-based assay) in the cerebrospinal fluid were enrolled. They were divided into two groups based on age (<16 years or older). RESULTS: Three children (two males and one female) and four adults (one male and three females) were examined...
June 12, 2020: Clinical Neurology and Neurosurgery
Anh-Vu Nguyen, Keith A Young, James A Bourgeois
Objective: To present a review of the literature on the clinical presentation and pathophysiology of anti-N-methyl-d-aspartate receptor encephalopathy (ANMDARE) with attention to both the more commonly recognized psychotic symptom prodrome and the less well-understood depressive symptom prodrome. Data Sources: The search for clinical neuropsychiatric phenomena and proposed mechanisms involved in ANMDARE pathophysiology was conducted in PubMed. English-language articles published up to September 2019 were identified using a combination of the following search terms: N-methyl-d-aspartate, anti-NMDA receptor encephalitis, schizophrenia, psychosis, depression, major depressive disorder, bipolar I disorder, bipolar II disorder, anxiety, and posttraumatic stress disorder...
June 18, 2020: Primary Care Companion to CNS Disorders
Chae Hyeong Lee, Eun Jung Kim, Min Hee Lee, Ga Won Yim, Kyeong Joon Kim, Kwang Ki Kim, Eo Jin Kim, Ju Won Roh
Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a potentially life-threatening but reversible autoimmune disorder characterized by psychiatric symptoms, cognitive dysfunction, speech dysfunction, seizures, movement disorder, decreased level of consciousness, and autonomic dysfunction or central hypoventilation. It occurs predominantly in young women and approximately half of them have underlying tumors, mainly ovarian teratoma. A 24-year old woman was admitted because of fever, headache, abnormal movement and decreased mental status...
June 22, 2020: Journal of Korean Medical Science
Raman Sohal, Steven H Adams, Vishal Phogat, Abha Harish, Carlos Ynigo D Lopez, Michael P A Williams, Kamal K Khurana, Basel Abuzuaiter, Nia Jagroop, Bhavya Narapureddy
Introduction: Paraneoplastic limbic encephalitis (PLE) is a rare disease that presents as rapid onset dementia characterized by short-term memory loss (STM), anxiety, and behavioral changes. Anti-NMDAR antibodies are unfrequently reported in PLE associated with small-cell lung cancer (SCLC). Given that PLE can precede the diagnosis of cancer, it is very important that once infectious, metabolic, nutritional, or structural disorders associated with short-term memory loss are ruled out that vigorous effort must be made to rule out underlying malignancy...
2020: Case Reports in Neurological Medicine
Romain Delangle, Sophie Demeret, Geoffroy Canlorbe, Leslie Chelon, Jérémie Belghiti, Clémentine Gonthier, Marianne Nikpayam, Catherine Uzan, Henri Azaïs
BACKGROUND: Anti-NMDA receptor antibody (anti-NMDAr) encephalitis, although still a rare condition, is well known to neurologists as it is the leading cause of non-infectious acute encephalitis in young women. However, this is less well known to gynecologists, who may have a decisive role in etiological management. Indeed, in 30-60% of cases in women of childbearing age, it is associated with the presence of an ovarian teratoma, whose removal is crucial in the resolution of symptomatology...
June 17, 2020: Archives of Gynecology and Obstetrics
Rui Liu, Mingkai Zhang, Lingling Liu, Gang Chen, Yiwei Hou, Meiling Wang, Jianmin Li
Several studies have certified that autoantibodies play an important role in the manifestation of neuromuscular diseases. Scientists have discovered specific neuronal tumor antibodies in patients with typical paraneoplastic neurological disorders. But in some clinical cases, it is not useful to cure this disease with common treatments unless the autoantibodies are addressed. In addition, recent studies have shown a close relationship between certain antibodies and neuronal surface proteins in some special cases...
June 18, 2020: Neuroimmunomodulation
Serena Marita Lazzarin, Marco Vabanesi, Giordano Cecchetti, Raffaella Fazio, Giovanna Franca Fanelli, Maria Antonietta Volonté, Angela Genchi, Antonino Giordano, Vittorio Martinelli, Sergio Colombo, Paolo Beccaria, Milena Mucci, Jacopo Peccatori, Massimo Filippi, Fabio Minicucci
Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a potentially fatal autoimmune disease, characterized by autoantibody-mediated neurotransmission impairment in multiple brain locations. The course of this condition often comprises altered mental status, autonomic dysfunctions, refractory seizures and hyperkinetic movement disorders. Available disease-modifying therapies include corticosteroids, i.v. immunoglobulins, plasma exchange, rituximab and cyclophosphamide. In a subgroup of patients not responding to B-cell depletion, bortezomib, a proteasome inhibitor, has shown promising evidence of efficacy...
June 13, 2020: Journal of Neurology
Guanzhong Ni, Wanrong Lin, Xiaodong Cai, Jiaming Qin, Li Feng, Shaofang Zhu, Liemin Zhou, Ziyi Chen
OBJECTIVES: Seizures are a prominent feature of anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis. Nearly half of brain magnetic resonance image (MRI) results are abnormal. The aim of our study was to evaluate the associations between seizures and brain MRI results in patients with anti-NMDAR encephalitis. METHODS: Patients with anti-NMDAR encephalitis were enrolled between January 2015 and December 2018. The patients included were divided into normal and abnormal MRI groups...
June 13, 2020: Acta Neurologica Scandinavica
Yuya Kobayashi, Mitsuto Sato, Michiaki Kinoshita, Masaki Kakizawa, Kayoko Higuchi, Yamada Mitsunori, Minori Kodaira, Yoshiki Sekijima
A 61-year-old Japanese man presented with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. NR1 antibodies were detected in his cerebrospinal fluid. Chest computed tomography revealed lung tumor. The patient was diagnosed with paraneoplastic anti-NMDAR encephalitis associated with lung cancer and treated with two cycles of intravenous high-dose methylprednisolone and one cycle of intravenous immunoglobulin. However, he died one year later without improvement. An autopsy confirmed small-cell lung cancer (SCLC)...
June 2, 2020: Internal Medicine
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