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
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
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
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
Yusuke Sakiyama, Eiji Matsuura, Ayano Shigehisa, Yuki Hamada, Mika Dozono, Satoshi Nozuma, Tomonori Nakamura, Keiko Higashi, Akihiro Hashiguchi, Yukitoshi Takahashi, Hiroshi Takashima
We herein report a 50-year-old man with alcoholic cirrhosis who developed loss of consciousness and tremor of the upper limbs. Magnetic resonance imaging findings were suggestive of limbic encephalitis with bilateral hippocampal damage, and a cerebrospinal fluid (CSF) examination confirmed anti-N-methyl-D-aspartate (NMDA) and anti-glutamate receptor antibodies. Despite initial corticosteroid therapy, meningeal irritation symptoms appeared, owing to the development of cryptococcal meningitis (CM), diagnosed by the detection of cryptococcal capsular polysaccharide antigen in the follow-up CSF analysis...
June 9, 2020: Internal Medicine
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
David Moreno-Ajona, Elena Prieto, Fabiana Grisanti, Inés Esparragosa, Lizeth Sánchez Orduz, Jaime Gállego Pérez-Larraya, Javier Arbizu, Mario Riverol
Brain positron emission tomography imaging with 18Fluorine-fluorodeoxyglucose (FDG-PET) has demonstrated utility in suspected autoimmune encephalitis. Visual and/or assisted image reading is not well established to evaluate hypometabolism/hypermetabolism. We retrospectively evaluated patients with autoimmune encephalitis between 2003 and 2018. Patients underwent EEG, brain magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) sampling and autoantibodies testing. Individual FDG-PET images were evaluated by standard visual reading and assisted by voxel-based analyses, compared to a normal database...
May 29, 2020: Diagnostics
Ana Paula Bornes da Silva, Rodrigo Braccini Madeira Silva, Leise Daniele Sckenal Goi, Rachel Dias Molina, Denise Cantarelli Machado, Douglas Kazutoshi Sato
Immune-mediated inflammatory diseases of the central nervous system (CNS) are a group of neurological disorders in which inflammation and/or demyelination are induced by cellular and humoral immune responses specific to CNS antigens. They include diseases such as multiple sclerosis (MS), neuromyelitis optica spectrum disorders (NMOSD), acute disseminated encephalomyelitis (ADEM) and anti-NMDA receptor encephalitis (NMDAR encephalitis). Over the years, many in vivo and in vitro models were used to study clinical, pathological, physiological and immunological features of these neuroimmunological disorders...
2020: Frontiers in Neurology
Sophie Meixensberger, Ludger Tebartz van Elst, Tina Schweizer, Simon J Maier, Harald Prüss, Bernd Feige, Dominik Denzel, Kimon Runge, Kathrin Nickel, Miriam Matysik, Nils Venhoff, Katharina Domschke, Horst Urbach, Evgeniy Perlov, Dominique Endres
Background: Anti-N-methyl-D-aspartate-receptor (NMDA-R) encephalitis is an autoimmune disease of the brain first described in 2007. The aim of this paper is to present a 10-year follow-up case history. Case Presentation: The authors present the case of a 39-year-old female patient who developed an anti-NMDA-R encephalitis in 2009 with predominant severe catatonic symptoms. Anti-inflammatory therapy led to the disappearance of catatonic symptoms and was discontinued during the course of the disease...
2020: Frontiers in Psychiatry
Nicola Warren, Cullen O'Gorman, Stefan Blum, Steve Kisely, Andrew Swayne, Joshua Flavell, Dan Siskind
OBJECTIVE: The gold standard for diagnosing anti-NMDAR encephalitis is demonstration of the antibody in CSF. Clinical diagnostic criteria have been proposed for when this is not available in a timely manner which is evaluated, in this study, for a psychiatric population. METHODS: This study retrospectively assessed the proposed criteria in patients presenting to psychiatric services for the first time with known anti-NMDAR antibody status. Antibody positive cases were derived from the literature (conception to December 2019) and a state wide (Queensland, Australia) cohort...
May 30, 2020: Acta Psychiatrica Scandinavica
T Wölk, M Schargus, G Seidel
This article reports the case of a 40-year-old male patient with isolated metamorphopsia and visual pseudohallucinations lasting for 2 weeks. As the ophthalmological findings were not pathological, a further neurological examination was performed. After diagnosis of anti-N-methyl-D-aspartate (NMDA) receptor encephalitis, which can be manifested in various psychiatric, neurological and ophthalmological ways, the oligosymptomatic patient received high-dose corticosteroid treatment with intravenous immunoglobulins, which stopped the symptoms...
May 19, 2020: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
Xingyu Liu, Mohan Giri, Weihao Ling, Tingsong Li
Optic neuritis is an inflammatory demyelinating disorder of the central nervous system. Anti-NMDA receptor (NMDAR) antibodies encephalitis is also mediated by the inappropriate immunological response. We report a girl who was readmitted because of unilateral eye pain and vision impairment in the remission period of anti-NMDAR encephalitis. Based on the limited available literature on the treatment of optic neuritis associated with anti-NMDA receptor antibody, she was treated with a combination of corticosteroids and intravenous immunoglobulin with clinical improvement...
March 2020: Neurology India
Ahmed Al Sinani, Said Al Maawali, Jalila Alshekaili, Mahmood Al Kindi, Khalsa Al Ramadhani, Jaber Al Khabouri, Ahmed Nadeem, Abdullah Al Salti
Neuromyelitis optica spectrum disorder (NMOSD) represents an evolving spectrum of inflammatory demyelinating central nervous system-based autoimmune diseases; while anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is another severe immune-mediated syndrome that occurs in association with IgG antibodies against the GluN1 subunit of the NMDAR and has been predominantly reported in young females (Dalmau et al., 2008 Dec). Although It has been recognized that anti-NMDAR encephalitis can coexist in the same patient who has serological markers of another autoimmune disease (e...
July 2020: Multiple Sclerosis and related Disorders
Bade Gulec, Hatice Kurucu, Suha Bozbay, Yalım Dikmen, Haluk Sayman, Erdem Tuzun, Melih Tutuncu, Ugur Uygunoglu, Cengiz Yalcinkaya, Sabahattin Saip, Aksel Siva
Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a serious autoimmune disorder characterized by psychiatric symptoms, seizures and movement disorder. Predisposing factors have been reported since the time it was described, and its pathophysiology has been tried to be clarified over the years. Although overlap with other demyelinating diseases had been reported, such an association between Multiple Sclerosis (MS) anti ANTİ-NMDAR encephalitis is limited to only a few case reports. In this article, a patient diagnosed with relapsing remitting multiple sclerosis (RRMS) for ten years who then developed NMDA-R encephalitis while on disease modifying treatment will be presented and possible common pathophysiology with previously reported literature will be discussed...
April 30, 2020: Multiple Sclerosis and related Disorders
Amanda R Tomlinson, Raia A Blum, Nathalie Jetté, Churl-Su Kwon, Ava Easton, Anusha K Yeshokumar
PURPOSE: The purpose of the study was to assess care transitions and caregiver burden among caregivers of individuals with anti-N-methyl-d-aspartate (NMDA) receptor encephalitis (anti-NMDARE). METHODS: Caregivers of individuals with anti-NMDARE were recruited via patient organization websites. Demographic and clinical information as well as responses to the Care Transition Measure 15 (CTM-15) and Zarit Burden Interview (ZBI) were collected. Exploratory factor analysis (EFA) was conducted on the ZBI, and underlying constructs were analyzed for associations with the CTM-15 and clinical characteristics...
May 3, 2020: Epilepsy & Behavior: E&B
Raia A Blum, Amanda R Tomlinson, Nathalie Jetté, Churl-Su Kwon, Ava Easton, Anusha K Yeshokumar
PURPOSE: The purpose of this study was to assess long-term psychosocial outcomes of anti-N-methyl-d-aspartate (NMDA) receptor encephalitis (anti-NMDARE). METHODS: Adolescents and adults with self-reported anti-NMDARE were invited to complete an online survey distributed by relevant patient organizations. Demographic and clinical information was collected, including the diagnoses initially given for anti-NMDARE symptoms and posthospital care received. Patient-Reported Outcomes Measurement Information System (PROMIS) Psychosocial Impact Illness - Negative short form (Negative PSII) was administered to assess psychosocial outcome of anti-NMDARE...
May 3, 2020: Epilepsy & Behavior: E&B
Amy Li Safadi, Tian Wang, Gianluca Di Maria, Amy Starr, Bronson E Delasobera, Carlos Alberto Mora, Carlo Tornatore
Few reports describe the clinical course and acute-care management of patients with recurrent multi-antibody paraneoplastic encephalitis. We describe a rare case of a patient having thymoma with multiple paraneoplastic syndromes who was found to have antibodies to α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) followed by N -methyl-d-aspartate (NMDA) receptor in the setting of residual thymic tissue. He initially presented to the hospital with severe, rapidly progressive encephalitis with simultaneous antibodies to AMPA and voltage-gated potassium channel complex receptor...
April 2020: Neurohospitalist
Dhruv Jain, Marcus C Ng
No abstract text is available yet for this article.
April 28, 2020: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
Xiaohui Miao, Pingqiao Yuan, Lihong Zhao, Le Zhang, Xinyue Jiang, Hanyu Cao, Hongrui Shi, Jinmei Li, Rong Yang
To identify the risk factors of pneumonia in patients with Anti-N-methyl-D-aspartate (Anti-NMDA) receptor encephalitis.This is a retrospective study.Department of Neurology in West China Hospital of Sichuan University.Patients with a definitive diagnosis of anti-NMDA receptor encephalitis.Risk factors associated with pneumonia were examined by bivariate analysis and multivariate logistic regression model.A total of 104 patients were included in this study, of which 41% patients (n = 43) were diagnosed with pneumonia at 7 days (range: 4-40 days) after admission...
April 2020: Medicine (Baltimore)
Glen Oriaifo
INTRODUCTION: Anti-NMDA (N-methyl-D-aspartate) receptor encephalitis often presents itself in psychiatric settings as first-break psychosis. I present a case of a 31-year-old female who returned to the clinic one year after being treated for NMDA receptor antibody encephalitis. CASE REPORT: Ms. C is a 31 y/o female who returned to the clinic after one year of being discharged from the hospital for NMDA-receptor encephalitis with positive serological NR1 antibodies...
April 2020: CNS Spectrums
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