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Anti-NMDAR encephalitis

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https://www.readbyqxmd.com/read/28535637/-analysis-of-prodromal-phase-and-prodromal-events-in-anti-n-methyl-d-aspartate-receptor-encephalitis
#1
Y Yao, B Peng, X H Wang, F Fang, D Xu, X L Xu, H T Ren, Y C Zhu, L Y Cui, H Z Guan
Objective: To analyze prodromal phase and prodromal events of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. Methods: Clinical data of 179 patients hospitalized and diagnosed during 2010-2016 including adults and children in Peking Union Medical College Hospital and Beijing Children's Hospital were collected.Patients with prodromal phase or prodromal events were selected.A retrospective analysis of clinical characteristics including prodromal phase or prodromal events, course of disease, brain imaging, laboratory results and therapeutic effect was performed...
May 23, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28527387/analysis-of-electroencephalogram-characteristics-of-anti-nmda-receptor-encephalitis-patients-in-china
#2
Yan Zhang, Gang Liu, Meng Di Jiang, Li Ping Li, Ying Ying Su
OBJECTIVE: To explore the characteristics of electroencephalogram (EEG) in patients with anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis. METHODS: Anti-NMDAR encephalitis patients admitted to the Department of Neurology between January 2012 and June 2016 were enrolled. All patients underwent electroencephalogram (EEG) at least once in the disease peak stage, and received tumor screening, symptomatic therapy, and immunotherapy. Patients received outcome evaluation every 6months after the immunotherapy, and modified Rankin scale (mRS) 0-2 was defined as favorable outcome...
May 4, 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/28503332/chronic-neuropsychological-sequelae-in-a-patient-with-nontumorous-anti-nmda-receptor-encephalitis
#3
Dong Y Han, Lisa M Koehl, Aarti Patel, Zhengqiu Zhou, Sarah Phillips, Siddharth Kapoor
Anti-N-methyl-D-aspartate receptor encephalitis is a neurological, autoimmune disorder tightly conceptualized only as recently as the mid-2000s. It presents itself in a combination of psychiatric, neurological, and autonomic features. We observe a unique case with probable earlier episode (prior to the mid-2000s conceptualization of the disease) and a later relapse, accompanying a comprehensive neuropsychological profile tracked after the relapse and subsequent improvement. Neurocognitive findings revealed residual frontal deficits with mood changes even in the state after plasmapheresis...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28470592/japanese-encephalitis-can-trigger-anti-n-methyl-d-aspartate-receptor-encephalitis
#4
Jiannan Ma, Ting Zhang, Li Jiang
Japanese encephalitis (JE) is usually a monophasic disease; however, in rare cases, patients with JE may have an early relapse after a partial recovery, giving rise to a biphasic pattern for the disease. In this study, we report three pediatric cases in which post-JE relapse was characterized by movement disorder and/or behavioral problems, and was related to anti-N-methyl-D-aspartate receptor (NMDAR) immunoglobulin G (IgG). Serum and cerebrospinal fluid were examined for anti-NMDAR IgG in three patients who had confirmed JE and then developed relapsing symptoms which were similar to those of anti-NMDAR encephalitis...
May 3, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28469537/rituximab-for-treatment-of-refractory-anti-nmda-receptor-encephalitis-in-a-pediatric-patient
#5
Sarah Hallowell, Esli Tebedge, Margaret Oates, Elizabeth Hand
Anti-N-methyl d-aspartate receptor (anti-NMDAR) encephalitis is a devastating disease that is increasingly being identified in both children and adults with psychosis, language disturbances, behavioral changes, and motor deficits. Currently no consensus guidelines exist for the optimal management of patients with this disease, although intravenous immune globulin (IVIG) therapy is often considered first-line pharmacotherapy. We present a case of an otherwise healthy 4 year-old-child who presented with seizures, loss of age-appropriate language skills, and behavioral changes, in whom anti-NMDAR was subsequently diagnosed...
March 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28461116/anti-neuronal-anti-bodies-in-patients-with-early-psychosis
#6
O Mantere, M Saarela, T Kieseppä, T Raij, T Mäntylä, M Lindgren, E Rikandi, W Stoecker, B Teegen, J Suvisaari
It may be challenging to distinguish autoimmune encephalitis associated with anti-neuronal autoantibodies from primary psychiatric disorders. Here, serum was drawn from patients with a first-episode psychosis (n=70) or a clinical high-risk for psychosis (n=6) and controls (n=34). We investigated the serum prevalence of 24 anti-neuronal autoantibodies: IgG antibodies for anti-N-methyl-d-aspartate-type glutamate receptor (anti-NMDAR), glutamate and γ-aminobutyric acid alpha and beta receptors (GABA-a, GABA-b), alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPA), glycine receptor (GlyR), metabotropic glutamate receptor 1 and 5 (mGluR1, mGluR5), anti-Tr/Delta/notch-like epidermal growth factor-related receptor (DNER), contactin-associated protein-like 2 (CASPR2), myelin oligodendrocyte glycoprotein (MOG), glutamic acid decarboxylase-65 (GAD65), collapsin response mediator protein 5/crossveinless-2 (CV2), aquaporin-4 (AQP4), anti-dipeptidyl-peptidase-like protein-6 (DPPX), type 1 anti-neuronal nuclear antibody (ANNA-1, Hu), Ri, Yo, IgLON5, Ma2, zinc finger protein 4 (ZIC4), Rho GTPase-activating protein 26, amphiphysin, and recoverin, as well as IgA and IgM for dopamine-2-receptor (DRD2)...
April 28, 2017: Schizophrenia Research
https://www.readbyqxmd.com/read/28445312/early-progression-of-brain-atrophy-in-patients-with-anti-n-methyl-d-aspartate-receptor-encephalitis-case-reports
#7
Hiroshi Kataoka, Nobuhiro Sawa, Yasuyo Tonomura, Satoshi Ueno
BACKGROUND: Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis responds to immunnotherapy, and approximately 80% of patients with this disorder fully recover or have only minor sequelae. Brain magnetic resonance imaging (MRI) does not show a specific abnormality, but some patients have progressive cerebral atrophy. The cerebral atrophy can become reversible after clinical improvement. METHODS: We describe 3 patients with diffuse cerebral atrophy (DCA) on serial brain MRI...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28439892/cerebrospinal-fluid-cyto-chemokine-profile-during-acute-herpes-simplex-virus-induced-anti-n-methyl-d-aspartate-receptor-encephalitis-and-in-chronic-neurological-sequelae
#8
Kavitha Kothur, Deepak Gill, Melanie Wong, Shekeeb S Mohammad, Sushil Bandodkar, Susan Arbunckle, Louise Wienholt, Russell C Dale
AIM: To examine the cytokine/chemokine profile of cerebrospinal fluid (CSF) during acute herpes simplex virus-induced N-methyl-d-aspartate receptor (NMDAR) autoimmunity and in chronic/relapsing post-herpes simplex virus encephalitis (HSE) neurological syndromes. METHOD: We measured longitudinal serial CSF cyto-/chemokines (n=34) and a glial marker (calcium-binding astroglial protein, S100B) in one patient during acute HSE and subsequent anti-NMDAR encephalitis, and compared the results with those from two patients with anti-NMDAR encephalitis without preceding HSE...
April 25, 2017: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/28439890/herpes-simplex-virus-induced-anti-n-methyl-d-aspartate-receptor-encephalitis-a-systematic-literature-review-with-analysis-of-43-cases
#9
REVIEW
Margherita Nosadini, Shekeeb S Mohammad, Francesco Corazza, Ezia Maria Ruga, Kavitha Kothur, Giorgio Perilongo, Anna Chiara Frigo, Irene Toldo, Russell C Dale, Stefano Sartori
AIM: To conduct a systematic literature review on patients with biphasic disease with herpes simplex virus (HSV) encephalitis followed by anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. METHOD: We conducted a case report and systematic literature review (up to 10 December 2016), focused on differences between herpes simplex encephalitis (HSE) and anti-NMDAR encephalitis phases, age-related characteristics of HSV-induced anti-NMDAR encephalitis, and therapy...
April 25, 2017: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/28298911/autoantibodies-against-the-n-methyl-d-aspartate-receptor-subunit-nr1-untangling-apparent-inconsistencies-for-clinical-practice
#10
REVIEW
Hannelore Ehrenreich
This viewpoint review provides an integrative picture of seemingly contradictory work published on N-methyl-d-aspartate receptor 1 (NMDAR1) autoantibodies (AB). Based on the present state of knowledge, it gives recommendations for the clinical decision process regarding immunosuppressive treatment. Brain antigen-directed AB in general and NMDAR1-AB in particular belong to a preexisting autoimmune repertoire of mammals including humans. Specific autoimmune reactive B cells may get repeatedly (perhaps transiently) boosted by various potential stimulants (e...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28284352/raised-cerebrospinal-fluid-baff-and-april-levels-in-anti-n-methyl-d-aspartate-receptor-encephalitis-correlation-with-clinical-outcome
#11
Bo Deng, Xiao-Ni Liu, Xiang Li, Xiang Zhang, Chao Quan, Xiang-Jun Chen
In this study, we aimed to assess the levels of B cell activating factor from the tumor necrosis factor family (BAFF) and a proliferation-inducing ligand (APRIL) in cerebrospinal fluid (CSF) of patients with anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis and determine their correlation with clinical outcome. BAFF and APRIL concentrations in CSF and serum from 40 patients with anti-NMDAR encephalitis and 20 controls were measured by enzyme-linked immunosorbent assay (ELISA). Compared with controls, the levels of both BAFF and APRIL in CSF were significantly increased in patients with anti-NMDAR encephalitis (p<0...
April 15, 2017: Journal of Neuroimmunology
https://www.readbyqxmd.com/read/28283100/antecedent-anti-nmda-receptor-encephalitis-in-two-patients-with-multiple-sclerosis
#12
A Baheerathan, W J Brownlee, D T Chard, K Shields, R Gregory, S A Trip
Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an autoimmune disorder characterised by psychiatric symptoms, movement disorder and seizures often evolving into a severe encephalopathy. An overlap has recently been recognised between anti-NMDAR encephalitis and inflammatory demyelinating disorders, particularly neuromyelitis optical spectrum disorder (NMOSD). In this case report, we describe two patients with an initial presentation consistent with anti-NMDAR encephalitis who have subsequently developed relapsing-remitting multiple sclerosis (MS) and discuss the literature pertaining to potential overlap between NMDAR encephalitis and inflammatory demyelinating disorders...
February 2017: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/28282627/anti-nmdar-encephalitis-followed-by-seropositive-neuromyelitis-optica-spectrum-disorder-a-case-report-and-literature-review
#13
REVIEW
Ye Ran, Lu Wang, Fangfang Zhang, Ran Ao, Zhao Dong, Shengyuan Yu
Neuromyelitis optica spectrum disorder (NMOSD) is an inflammatory central nervous system syndrome, and encephalitis associated with anti-N-methyl-d-aspartate receptor (NMDAR) antibodies is an autoimmune encephalopathy. A patient with both diseases, separately or simultaneously, is rare as a clinical phenomenon, but cannot be ignored. We report the clinical characteristics and imaging features of a special case with anti-NMDAR encephalitis followed by NMOSD. We subsequently reviewed the English language literature about demyelinating disorders with anti-NMDAR encephalitis...
April 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28272206/limbic-encephalitis-associated-with-anti-nh2-terminal-of-%C3%AE-enolase-antibodies-a-clinical-subtype-of-hashimoto-encephalopathy
#14
Toru Kishitani, Akiko Matsunaga, Masamichi Ikawa, Kouji Hayashi, Osamu Yamamura, Tadanori Hamano, Osamu Watanabe, Keiko Tanaka, Yasunari Nakamoto, Makoto Yoneda
Several types of autoantibodies have been reported in autoimmune limbic encephalitis (LE), such as antibodies against the voltage-gated potassium channel (VGKC) complex including leucine-rich glioma inactivated 1 (LGI1). We recently reported a patient with autoimmune LE and serum anti-NH2-terminal of α-enolase (NAE) antibodies, a specific diagnostic marker for Hashimoto encephalopathy (HE), who was diagnosed with HE based on the presence of antithyroid antibodies and responsiveness to immunotherapy. This case suggests that LE patients with antibodies to both the thyroid and NAE could be diagnosed with HE and respond to immunotherapy...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28262407/anti-n-methyl-d-aspartate-receptor-encephalitis-associated-with-hepatic-neuroendocrine-carcinoma-a-case-report
#15
Ee Wei Lim, Chun Wai Yip
Anti-N-methyl-D-aspartate receptor (Anti-NMDAR) encephalitis can present with and without tumor. Tumor associations are less common in older patients. We report a 65-year-old gentleman who presented with one week history of cough, chills, rigor and altered behavior, followed by florid visual and auditory hallucinations. Mini mental status examination score was 16/30. Both cerebrospinal fluid and plasma anti-NMDA receptor antibodies were detected. A course of intravenous methylprednisolone was given with partial symptom improvement...
March 2, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28262035/lesions-of-the-posterior-limb-of-the-internal-capsule-in-neuromyelitis-optica-spectrum-disorder
#16
Youming Long, Linzhan Wu, Rong Zhong, Xiaoming Ouyang, Junyan Liang, Cong Gao, Xiaohui Chen, Wei Qiu, Yanyu Chang, Zhanhang Wang, Jinlong Ye
Posterior limb of the internal capsule lesions (PLICL) are one of the MRI features of neuromyelitis optica spectrum disorder (NMOSD). However, there is no evidence that such lesions are pathogenically related to NMOSD. We retrospectively analyzed features of PLICL in NMOSD, and other central nervous system inflammatory disorders, in 561 patients. We also examined the pathological samples of six patients. Of the 561 patients investigated, PLICL were found in 65 patients (11.6%). Lesions were bilateral in 26 cases (40%) and unilateral in 39 cases (60%)...
May 2017: Neurological Research
https://www.readbyqxmd.com/read/28259863/-review-of-the-psychiatric-aspects-of-anti-nmda-n-methyl-d-aspartic-acid-receptor-encephalitis-case-report-and-our-plans-for-a-future-study
#17
Levente Herman, Ildiko Reka Zsigmond, Laszlo Peter, Janos M Rethelyi
Anti-NMDAR (N-methyl-D-aspartic acid receptor) encephalitis, first described in 2007, is a rare, autoimmune limbic encephalitis. In half of the cases anti-NMDAR antibodies are paraneoplastic manifestations of an underlying tumor (mostly ovarian teratoma). In the early stage of the disease psychiatric symptoms are prominent, therefore 60-70% of the patients are first treated in a psychiatric department. In most of the cases, typical neurological symptoms appear later. Besides the clinical picture and typical symptoms, verifying presence of IgG antibodies in the serum or CSF is necessary to set up the diagnosis...
December 2016: Neuropsychopharmacologia Hungarica
https://www.readbyqxmd.com/read/28251511/herpes-simplex-encephalitis-an-update
#18
REVIEW
John W Gnann, Richard J Whitley
PURPOSE OF REVIEW: The goal of this review is to provide an update on current thinking regarding herpes simplex encephalitis (HSE), emphasizing new information about pathogenesis, diagnosis, and immune responses. Specific questions to be addressed are the following: (1) Is there a genetic predisposition to HSE? (2) What clinical approaches have the greatest impact on improving the long-term outcomes in patients with HSE? And (3) are there immune-mediated mechanisms that may account for relapsing HSE? RECENT FINDINGS: Toll-like receptor 3 (TLR 3) plays an important role in innate immune responses, including generation of interferons...
March 2017: Current Infectious Disease Reports
https://www.readbyqxmd.com/read/28223808/n-methyl-d-aspartate-receptor-antibody-could-be-a-cause-of-catatonic-symptoms-in-psychiatric-patients-case-reports-and-methods-for-detection
#19
Ko Tsutsui, Takashi Kanbayashi, Manabu Takaki, Yuki Omori, Yumiko Imai, Seiji Nishino, Keiko Tanaka, Tetsuo Shimizu
The symptoms of catatonia have been reported to be similar to the initial symptoms of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. Subsequently, this autoimmune limbic encephalitis has been noticed by many psychiatrists. For a differential diagnosis of catatonic state, it is important to detect anti-NMDAR encephalitis. This encephalitis is expected to be in remission by early detection and treatment. We should be more cautious about catatonic symptoms of schizophrenia. When a patient is suspected of having encephalitis, we should screen for anti-NMDAR antibodies in cerebrospinal fluid samples using a cell-based assay...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28209905/diagnostic-value-of-18-f-fdg-pet-ct-versus-mri-in-the-setting-of-antibody-specific-autoimmune-encephalitis
#20
Lilja B Solnes, Krystyna M Jones, Steven P Rowe, Puskar Pattanayak, Abhinav Nalluri, Arun Venkatesan, John C Probasco, Mehrbod Som Javadi
Introduction: Diagnosis of autoimmune encephalitis presents some challenges in the clinical setting due to varied clinical presentations and delay in obtaining antibody panel results. We examined the role of neuroimaging in the setting of autoimmune encephalitides comparing the utility (18)F-FDG PET/CT versus conventional brain imaging with MRI. Methods: A retrospective study was performed assessing the positivity rate of MRI versus (18)F-FDG PET/CT during the initial work-up of 23 patients proven to have antibody positive autoimmune encephalitis...
February 16, 2017: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
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