Read by QxMD icon Read

nmda receptor encephalitis iv immunoglobulins

Chikako Kaneko, Norshalena Shakespear, Mario Tuchiya, Jin Kubo, Teiji Yamamoto, Soichi Katayama, Yukitoshi Takahashi
Five consecutive cases of anti-NMDA-receptor encephalitis that we encountered were marked by a rapidly fluctuating level of consciousness associated with psychotic and delirious mental states. Opisthotonus, catatonia, and rhythmic and non-rhythmic involuntary movements of the mouth and jaw were also characteristic features of these particular cases. Serious and potentially fatal problems included epilepsia partialis continua, partial and generalized seizures, and respiratory depression, resembling the symptoms of encephalitis lethargica...
September 2016: Brain and Nerve, Shinkei Kenkyū No Shinpo
Andrew McKeon
PURPOSE OF REVIEW: This article describes the methods of diagnosis and management of autoimmune encephalopathies and dementias. The expedited distinction of autoimmune encephalopathies and dementias from neurodegenerative disorders is important because treatment is most effective at the early stage of illness. RECENT FINDINGS: The spectrum of antibody biomarkers of treatable autoimmune encephalopathies continues to broaden and now includes antibodies targeting glutamate receptors (N-methyl-D-aspartate [NMDA] and α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid [AMPA]), γ-aminobutyric acid A and B (GABA-A and GABA-B) receptors, glycine receptors, potassium channel complexes (Kv1, which includes leucine-rich, glioma inactivated 1 [LgI1], contactin-associated proteinlike 2 [CASPR2], and unknown specificity, and Kv4...
April 2016: Continuum: Lifelong Learning in Neurology
Renu Suthar, Arushi Gahlot Saini, Naveen Sankhyan, Jitendra Kumar Sahu, Pratibha Singhi
OBJECTIVES: To study the clinical profile, and outcome of children with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. METHODS: This is a retrospective case series of children <12 y of age, diagnosed with anti-NMDAR encephalitis at a tertiary care institute during the period, May 2013 through June 2015. RESULTS: Twenty patients were tested for suspected anti-NMDAR encephalitis over this 2 y period. Of these, six children were positive for anti-NMDAR antibodies...
July 2016: Indian Journal of Pediatrics
Lídia Hau, Györgyi Csábi, Tamás Tényi
OBJECTIVE: Anti-N-methyl-D-Aspartate encephalitis is a recently diagnosed autoimmune disorder with increasing significance. During this disease antibodies are produced against the subunit of the NMDA receptor, which cause different symptoms, both psychiatric and neurological. The aim of this publication is to introduce this disease, to facilitate the diagnosis and to recommend therapeutical guideline. MATERIALS AND METHODS: In this review we summarized the relevant literature published between 2007 and 2015 giving emphasis on etiopathogenesis, diagnosis, differential diagnosis, treatment and prognosis...
2015: Psychiatria Hungarica: A Magyar Pszichiátriai Társaság Tudományos Folyóirata
Amr A Matoq, Adam S Rappoport, Yiting Yang, Jessica O'Babatunde, Rubina Bakerywala, Raj D Sheth
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...
2015: Epilepsy & Behavior Case Reports
Hsiuying Wang
Treatments for anti-N-methyl-D-aspartate (NMDA) receptor encephalitis include immunotherapy with steroids, intravenous immunoglobulin, plasma exchange, or plasmapheresis as first-line treatments, immunotherapy with rituximab or cyclophosphamide as second-line treatments, and tumor removal. In this systematic review, we evaluated previous studies and examined the association between certain microRNAs and anti-NMDA receptor encephalitis to investigate the performance of different treatment combinations. The efficacies of different combinations of treatments classified into the following four categories were compared: (I) intravenous immunoglobulin administration, (II) plasmapheresis or plasma exchange, (III) treatment with rituximab or cyclophosphamide and (IV) tumor removal...
2016: Frontiers in Bioscience (Landmark Edition)
Kurt-Wolfram Sühs, Florian Wegner, Thomas Skripuletz, Corinna Trebst, Said Ben Tayeb, Peter Raab, Martin Stangel
Anti-N-methyl D-aspartate (NMDA) receptor encephalitis is the most common type of encephalitis in the spectrum of autoimmune encephalitis defined by antibodies targeting neuronal surface antigens. In the present study, the clinical spectrum of this disease is presented using instructive cases in correlation with the anti-NMDA receptor antibody titers in the cerebrospinal fluid (CSF) and serum. A total of 7 female patients admitted to the hospital of Hannover Medical School (Hannover, Germany) between 2008 and 2014 were diagnosed with anti-NMDA receptor encephalitis...
October 2015: Experimental and Therapeutic Medicine
Arzu Çoban, Gökçen Gündoğdu, Mürüvvet Poyraz, Gülçin Yegen, Aslı Demirtaş-Tatlıdede, Başar Bilgiç, Hasmet A Hanagasi, Erdem Tüzün, Hakan Gürvit
PURPOSE: N-methyl-D-aspartate receptor (NMDAR) encephalitis may present as a paraneoplastic syndrome in young women and is often associated with ovarian teratoma. METHODS: We report 2 male cases of NMDAR encephalitis presenting with metastatic cancer of unknown primary origin. RESULTS: Both patients showed cognitive dysfunction as well as other neurological symptoms, slow waves on EEG, and NMDAR antibodies in sera and CSF. Symptoms were effectively treated by pulse steroid and intravenous immunoglobulin treatment...
October 20, 2015: Tumori
Murat Sutcu, Hacer Akturk, Ayper Somer, Burak Tatli, Selda Hancerli Torun, Edibe Pembegul Yıldız, Guntulu Şık, Agop Citak, Ali Agacfidan, Nuran Salman
Post-herpes simplex virus encephalitis relapses have been recently associated with autoimmunity driven by autoantibodies against N-methyl-d-aspartate (NMDA) receptors. Because it offers different treatment options, determination of this condition is important. Between 2011 and 2014, 7 children with proven diagnosis of herpes simplex virus encephalitis were identified in a university hospital of Istanbul. Two patients had neurologic relapse characterized mainly by movement disorders 2 to 3 weeks after initial encephalitis...
March 2016: Journal of Child Neurology
Stéphane Mathis, Jean-Christophe Pin, Fabrice Pierre, Jonathan Ciron, Anna Iljicsov, Matthias Lamy, Jean-Philippe Neau
Anti-N-methyl-D-aspartate receptor (anti-MMDAR) encephalitis is an immune-mediated encephalitis mainly affecting young women.We describe the case of a 21-year-old woman who developed a classical form of anti-NMDAR encephalitis during the 10th week of gestation. The patient had been treated with methylpredinsolone and intravenous immunoglobulins. Birth history of the child was normal, with normal APGAR score. The clinical symptoms of the patient have improved after a few months.This rare occurrence during pregnancy (only 9 other cases described) presents an opportunity to highlight the importance of making the earliest possible diagnosis of this treatable and potentially reversible encephalitis, and to educate gynecologists, psychiatrists, anesthetists, and neurologists on this potential cause of psychiatric and neurological manifestations during pregnancy...
July 2015: Medicine (Baltimore)
Anastasia Zekeridou, Evgenia Karantoni, Aurélien Viaccoz, François Ducray, Cyril Gitiaux, Frédéric Villega, Kumaran Deiva, Veronique Rogemond, Elodie Mathias, Géraldine Picard, Marc Tardieu, Jean-Christophe Antoine, Jean-Yves Delattre, Jerome Honnorat
The objective of this study is to describe the treatment and outcome of children and adolescents with N-methyl-D-aspartate receptor (NMDA-R) encephalitis. A retrospective study of children and adolescents with NMDA-R encephalitis was performed by the French Paraneoplastic Neurological Syndrome Reference Center between January 1, 2007 and December 31, 2012. The modified Rankin scale (mRS) was used to assess outcome. Thirty-six children and adolescents with NMDA-R encephalitis were studied. All of the patients received first-line immunotherapy (corticosteroids, intravenous immunoglobulins or plasma exchange), and 81% received second-line immunotherapy (rituximab or cyclophosphamide)...
August 2015: Journal of Neurology
Leah M Lamale-Smith, Gaea S Moore, Saketh R Guntupalli, Julie B Scott
BACKGROUND: Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is a neuroautoimmune disease commonly associated with ovarian teratomas. It is characterized by neuropsychiatric symptoms, seizures, and autonomic instability. Few cases are described in pregnancy, and little is known about potential fetal effects. CASE: Anti-NMDA receptor encephalitis was diagnosed at 24 weeks of gestation. No improvement occurred with intravenous immunoglobulin, methylprednisolone, and plasmapheresis...
May 2015: Obstetrics and Gynecology
Allen D DeSena, Daniel K Noland, Karen Matevosyan, Kathryn King, Lauren Phillips, Sara S Qureshi, Benjamin M Greenberg, Donna Graves
INTRODUCTION: Anti-N-methyl-d-aspartate (NMDA) receptor antibody encephalitis is an increasingly recognized form of autoimmune encephalitis. Conventional treatments include therapies such as corticosteroids, intravenous immunoglobulin (IVIg), and/or therapeutic plasma exchange (TPE). Although TPE is regularly used for treatment of anti-NMDA receptor antibody encephalitis, the American Society for Apheresis has given it a category III recommendation only. Earlier administered immunotherapies in tumor-negative patients may facilitate faster recoveries, but it remains unclear whether or not TPE is superior to steroids and/or IVIG...
August 2015: Journal of Clinical Apheresis
Yael Hacohen, Michael Absoud, Cheryl Hemingway, Leslie Jacobson, Jean-Pierre Lin, Mike Pike, Sunil Pullaperuma, Ata Siddiqui, Evangeline Wassmer, Patrick Waters, Sarosh R Irani, Camilla Buckley, Angela Vincent, Ming Lim
OBJECTIVE: To report the clinical and radiologic findings of children with NMDA receptor (NMDAR) antibodies and white matter disorders. METHOD: Ten children with significant white matter involvement, with or without anti-NMDAR encephalitis, were identified from 46 consecutive NMDAR antibody-positive pediatric patients. Clinical and neuroimaging features were reviewed and the treatment and outcomes of the neurologic syndromes evaluated. RESULTS: THREE DISTINCT CLINICORADIOLOGIC PHENOTYPES WERE RECOGNIZED: brainstem encephalitis (n = 3), leukoencephalopathy following herpes simplex virus encephalitis (HSVE) (n = 2), and acquired demyelination syndromes (ADS) (n = 5); 3 of the 5 with ADS had myelin oligodendrocyte glycoprotein as well as NMDAR antibodies...
June 2014: Neurology® Neuroimmunology & Neuroinflammation
Andrea P Mann, Elena Grebenciucova, Rimas V Lukas
OBJECTIVE: Anti-N-methyl-D-aspartate-receptor (NMDA-R) encephalitis is a new autoimmune disorder, often paraneoplastic in nature, presenting with complex neuropsychiatric symptoms. Diagnosed serologically, this disorder is often responsive to immunosuppressant treatment. The objective of this review is to educate clinicians on the challenges of diagnosis and management of this disorder. MATERIALS AND METHODS: A review of the relevant literature on clinical presentation, pathophysiology, and recommended management was conducted using a PubMed search...
2014: Therapeutics and Clinical Risk Management
L Le Moigno, D Ternant, G Paintaud, G Thibault, S Cloarec, M Tardieu, E Lagrue, P Castelnau
INTRODUCTION: Anti-N-methyl-D-aspartate receptor (NMDA-R) encephalitis is little known to pediatricians and likely underdiagnosed. The child's vital and cognitive prognosis is at stake. The use of immunomodulatory drugs, such as rituximab has led to spectacular results, but many questions remain about its mode of action in this type of pathology. CASE REPORT: We report the case of a 6-year-old girl with no medical history, admitted for status epilepticus preceded by behavior symptoms and sleep disorders...
June 2014: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Preetha S Kuppuswamy, Christopher Robert Takala, Christopher L Sola
Anti-NMDA receptor (NMDAR) encephalitis, formally recognized in 2007, has been increasingly identified as a significant cause of autoimmune and paraneoplastic encephalitis. Approximately 80% of the patients are females. The characteristic syndrome evolves in several stages, with approximately 70% of the patients presenting with a prodromal phase of fever, malaise, headache, upper respiratory tract symptoms, nausea, vomiting and diarrhoea. Next, typically within two weeks, patients develop psychiatric symptoms including insomnia, delusions, hyperreligiosity, paranoia, hallucinations, apathy and depression...
July 2014: General Hospital Psychiatry
Alana Salvucci, Irisa M Devine, David Hammond, Raj D Sheth
BACKGROUND: We report the clinical features and course of pediatric patients presenting with anti-N-methyl D-aspartate receptor (NMDA-R) encephalitis. METHODS: Single-center 4-year observational study of pediatric encephalitis associated with NMDA-R antibodies in the serum and/or the cerebrospinal fluid. RESULTS: Three girls with anti-NMDA-R encephalitis were identified. All presented with an acute hyperkinetic movement disorder and seizures, expressive aphasia, and emotional lability requiring inpatient treatment for 1-3 months...
May 2014: Pediatric Neurology
Susan Byrne, Blathanid McCoy, Bryan Lynch, David Webb, Mary D King
N-methyl-d-aspartate (NMDA) receptor encephalitis is a treatable cause of autoimmune encephalitis in both children and adults. It is still unclear if the natural history of the condition in children is altered by early treatment with immunosuppressive therapy. We looked at the outcomes of five children (two males, three females; mean age 6y 9mo, range 4-8y) who were treated empirically for autoimmune encephalitis within a brief period of presentation. Features that led clinicians to suspect autoimmune encephalitis included prominent neuropsychiatric features, movement disorder, seizures, and dysautonomic features...
August 2014: Developmental Medicine and Child Neurology
Bhawna Sharma, Rahul Handa, Swayam Prakash, Kadam Nagpal, Pankaj Gupta
Anti-NMDA receptor encephalitis was first described in 2005 when psychiatric features, memory loss and altered consciousness were found in four women with ovarian teratoma. We report a case of anti-NMDA receptor encephalitis in a 16-year-old female who presented with psychiatric features followed by autonomic dysfunction and orofacial dyskinesias that showed drastic improvement to intravenous immunoglobulin. As many patients of anti-NMDAR encephalitis initially present with psychiatric features, it is important for psychiatrists to have high index of suspicion for this disease and thus avoid the delay in diagnosing this treatable condition which may be otherwise fatal...
February 2014: Asian Journal of Psychiatry
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"