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Emergency Department Presentations of Anti-N-Methyl-D-Aspartate Receptor Encephalitis.

Joseph Fisher, Clifford Ellingson, Noah Tolby
Anti-N-methyl-d-aspartate antibody receptor (NMDAR) encephalitis is a newly recognized disease increasing in diagnostic frequency. A 27-year-old female presented with symptoms of oral dyskinesia, tachycardia, and altered mental status following a three-month history of depression, lethargy, catatonia, and auditory hallucinations. We utilized our facilities neurology and psychiatry consult services, performed a lumbar puncture (LP), and requested NMDAR antibody titers. Following admission the Anti-NMDAR antibody titer was elevated warranting treatment with intravenous immunoglobulin (IVIG), corticosteroids, and later rituximab...
July 2017: American Journal of Emergency Medicine
Zhimin Liao, Xiaoqin Jiang, Juan Ni
A 24-year-old woman at 29 weeks' gestation, and with psychiatric symptoms, was admitted to hospital and diagnosed as having anti-N-methyl-D-aspartate receptor encephalitis. After 4 weeks of immunotherapy with little effect, an emergency cesarean section was performed at 33(+4) weeks gestation under general anesthesia. The parturient was intubated after rapid sequence induction with etomidate, remifentanil and succinylcholine. Anesthesia was maintained with sevoflurane and remifentanil. Except for low weight, the infant was normal at birth...
April 2017: Journal of Anesthesia
Michael Weaver, Richard T Griffey
BACKGROUND: Anti-N-methyl-d-aspartate (NMDA) receptor autoimmune encephalitis is a newly identified form of encephalitis whose incidence is on the rise. Awareness of this condition and symptom recognition are key to early diagnosis and prompt treatment, which may alter the course of the disease. CASE REPORT: A 35-year-old woman presented to our Emergency Department (ED) with lethargy, bizarre behavior, agitation, confusion, memory deficits, and word-finding difficulties...
August 2016: Journal of Emergency Medicine
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No abstract text is available yet for this article.
February 2016: Pediatric Emergency Care
Keith K Abe, Roshni L Koli, Loren G Yamamoto
Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is an acute autoimmune neurological disorder that presents with acute to subacute psychiatric and/or neurological complaints including new onset behavioral changes that may evolve to psychosis and catatonia, cognitive decline, new onset seizures, progressive encephalopathy, and/or movement disorders. Female teens and adults often have an associated ovarian teratoma as an underlying etiology, but most pediatric patients do not have an identifiable associated neoplasm...
February 2016: Pediatric Emergency Care
Brodie Nolan, Katharina Plenk, David Carr
Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a recently described and underdiagnosed entity that typically affects young, previously healthy individuals. Patients usually present in phases, which may include refractory seizures, psychosis, unresponsiveness, and autonomic instability. The diagnosis of anti-NMDAR encephalitis is challenging; however, prompt diagnosis and early treatment can lead to complete recovery. The incidence of anti-NMDAR encephalitis may be as high as four times that of encephalitis from herpes simplex, varicella-zoster, and West Nile viruses; however, it remains an underrecognized disorder...
September 2014: CJEM
Cherie P Hegarty, Jane E Mikli
A 17-year-old woman presented to the ED with behavioural disturbance and psychotic features. Brief dystonic jerks were noted so she was referred to the medical team. A diagnosis of anti-N-methyl-D-aspartate receptor encephalitis was made. Immunotherapy was instituted early and the clinical outcome was excellent. It is important to consider this condition in young women presenting with acute behavioural or psychotic symptoms.
February 2013: Emergency Medicine Australasia: EMA
E M Goldberg, K S Taub, S K Kessler, N S Abend
A previously healthy 9-year-old girl presented to an emergency department (ED) with headache, dizziness, blurry vision, and abnormal visual perceptions. She was diagnosed with migraine, treated symptomatically, and discharged. Over the course of days, she became progressively somnolent, and returned to the ED, where she was found to have a right inferior quadrantanopsia and sixth nerve palsy. Magnetic resonance imaging (MRI) of the brain showed gyral swelling of the left parieto-occipital lobe. Continuous electroencephalogram (EEG) monitoring revealed focal non-convulsive status epilepticus (NCSE) in the left occipital region...
October 2011: Neuropediatrics
Satoshi Kamei, Shigeki Kuzuhara, Masaki Ishihara, Akihiko Morita, Naoto Taira, Masaki Togo, Makoto Matsui, Masafumi Ogawa, Kinya Hisanaga, Tomohiko Mizutani, Sadako Kuno
OBJECTIVE: To study the incidence and clinical features of acute juvenile female non-herpetic encephalitis (AJFNHE) in Japan. METHODS: A nationwide questionnaire on patients with severe non-herpetic encephalitis of unknown etiology with a prolonged clinical course or death was sent to the departments of Internal Medicine, Neurology, Pediatrics, and Emergency and Critical Care at all hospitals with 200 beds or more in Japan. RESULTS: The recovery rate was 25% (1,279 out of 5,030 departments) and 90 patients were enrolled in this study...
2009: Internal Medicine
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