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Anti-NMDAR encephalitis

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https://www.readbyqxmd.com/read/29159196/botulinum-toxin-treatment-for-hypersalivation-in-anti-nmda-receptor-encephalitis
#1
Jin-Sun Jun, Han Gil Seo, Soon-Tae Lee, Kon Chu, Sang Kun Lee
Hypersalivation is one of the intractable symptoms of anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis. While anticholinergic medications partially improve the hypersalivation, they can aggravate the autonomic dysfunctions associated with anti-NMDAR encephalitis. Thus, we investigated the efficacy and safety of botulinum toxin type A injection on hypersalivation refractory to anticholinergics in six patients with anti-NMDAR encephalitis. Hypersalivation was well-controlled without remarkable adverse reaction over 16 weeks after botulinum toxin type A, although two patients were reinjected at 12 weeks due to reaggravation of hypersalivation...
November 2017: Annals of Clinical and Translational Neurology
https://www.readbyqxmd.com/read/29159189/nmdar-encephalitis-passive-transfer-from-man-to-mouse-by-a-recombinant-antibody
#2
Manish Malviya, Sumanta Barman, Kristin S Golombeck, Jesús Planagumà, Francesco Mannara, Nathalie Strutz-Seebohm, Claudia Wrzos, Fatih Demir, Christine Baksmeier, Julia Steckel, Kim Kristin Falk, Catharina C Gross, Stjepana Kovac, Kathrin Bönte, Andreas Johnen, Klaus-Peter Wandinger, Elena Martín-García, Albert J Becker, Christian E Elger, Nikolaj Klöcker, Heinz Wiendl, Sven G Meuth, Hans-Peter Hartung, Guiscard Seebohm, Frank Leypoldt, Rafael Maldonado, Christine Stadelmann, Josep Dalmau, Nico Melzer, Norbert Goebels
Objective: Autoimmune encephalitis is most frequently associated with anti-NMDAR autoantibodies. Their pathogenic relevance has been suggested by passive transfer of patients' cerebrospinal fluid (CSF) in mice in vivo. We aimed to analyze the intrathecal plasma cell repertoire, identify autoantibody-producing clones, and characterize their antibody signatures in recombinant form. Methods: Patients with recent onset typical anti-NMDAR encephalitis were subjected to flow cytometry analysis of the peripheral and intrathecal immune response before, during, and after immunotherapy...
November 2017: Annals of Clinical and Translational Neurology
https://www.readbyqxmd.com/read/29153996/clinical-presentation-of-anti-n-methyl-d-aspartate-receptor-and-anti-voltage-gated-potassium-channel-complex-antibodies-in-children-a-series-of-24-cases
#3
Bahadir Konuskan, Mirac Yildirim, Haluk Topaloglu, Ilknur Erol, Ulkuhan Oztoprak, Huseyin Tan, Rahsan Gocmen, Banu Anlar
OBJECTIVE: The symptomatology and paraclinical findings of antibody-mediated encephalitis, a relatively novel disorder, are still being characterized in adults and children. A high index of suspicion is needed in order to identify these cases among children presenting with various neurological symptoms. The aim of this study is to examine the clinical, demographic and laboratory findings and outcome of children with anti-NMDAR and anti-VGKC encephalitis for any typical or distinctive features...
November 7, 2017: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/29141829/cerebral-cortical-encephalitis-followed-by-recurrent-cns-demyelination-in-a-patient-with-concomitant-anti-mog-and-anti-nmda-receptor-antibodies
#4
Lei Zhou, Jingzi ZhangBao, Haiqing Li, Xiaoyang Li, Yongheng Huang, Min Wang, Chongbo Zhao, Jiahong Lu, Chuanzhen Lu, Yuxin Li, Chao Quan
We report the case of a patient who initially presented with fever, headache and seizure. MRI revealed a fluid attenuation inversion recovery (FLAIR) high-intensity lesion involving the right temporal, parietal and occipital cortex. Afterwards, the patient developed three recurrent episodes, manifested as brainstem encephalitis, optic neuritis and ADEM-like illness successively, indicating demyelination. Both of his serum anti-MOG and CSF anti-NMDAR antibodies were proved positive by transfected cell based assays...
November 2017: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/29128985/resection-of-melanocytic-nevi-as-a-potential-treatment-of-anti-nmdar-encephalitis-patients-without-tumor-report-of-three-cases
#5
Hexiang Yin, Chenyu Zhu, Haitao Ren, Xunzhe Yang, Bin Peng, Liying Cui, Tao Qu, Hongzhi Guan
The most common underlying tumor associated with anti-N-methyl D-aspartate-receptor (NMDAR) encephalitis is ovarian teratoma. Resection of the underlying tumor may decrease exposure of autoantigen and make for faster response of immunotherapy and less relapse frequency. Similar to teratoma, expression of NMDAR in human epidermal melanocytes was suspected recently. The dense melanocytes in melanocytic nevus may serve as potential autoantigens and are prone to increase relapse frequency in the tumor-negative patients...
November 11, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/29122401/the-efficacy-of-adrenocorticotropic-hormone-in-a-girl-with-anti-n-methyl-d-aspartate-receptor-encephalitis
#6
Mari Hatanaka, Shuichi Shimakawa, Akihisa Okumura, Jun Natsume, Miho Fukui, Shohei Nomura, Mitsuru Kashiwagi, Hiroshi Tamai
BACKGROUND: Immunomodulatory therapy has shown some therapeutic benefits in patients with anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis. In this report, we describe the use of adrenocorticotropic hormone (ACTH) immunotherapy with good outcome in a patient with anti-NMDAR encephalitis. SUBJECT AND METHODS: A 4-year-old girl developed convulsions in her right arm and leg without impaired consciousness. These convulsions occurred frequently in clusters of 10-20 events of 10-20 s duration...
November 6, 2017: Brain & Development
https://www.readbyqxmd.com/read/29101253/superficial-white-matter-damage-in-anti-nmda-receptor-encephalitis
#7
Owen Robert Phillips, Shantanu H Joshi, Katherine L Narr, David W Shattuck, Manpreet Singh, Margherita Di Paola, Christoph J Ploner, Harald Prüss, Paul Friedemann, Carsten Finke
BACKGROUND: Clinical brain MRI is normal in the majority of patients with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. However, extensive deep white matter damage wasrecently identifiedin these patients using diffusion weighted imaging. Here, our aim was to study a particularly vulnerable brain compartment, the late myelinating superficial white matter. METHODS: Forty-six patients with anti-NMDAR encephalitis were included. Ten out of these were considered neurologically recovered (modified Rankin scale of zero), while 36 patients were non-recovered...
November 3, 2017: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/29098690/seizure-outcomes-in-patients-with-anti-nmdar-encephalitis-a-follow-up-study
#8
Xu Liu, Bo Yan, Rui Wang, Chen Li, Chu Chen, Dong Zhou, Zhen Hong
OBJECTIVE: To evaluate the long-term seizure outcome and potential factors associated with seizure outcome in patients with anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis. METHODS: In the setting of a prospective, single-center, longitudinal cohort study, 109 patients were evaluated with ongoing follow-up. Patients underwent clinical evaluation every 3 months. Seizure outcomes and the potential risk factors were assessed with a median follow-up of 24 months (6-60 months)...
November 3, 2017: Epilepsia
https://www.readbyqxmd.com/read/29097081/paraneoplastic-autoimmune-movement-disorders
#9
Thien Thien Lim
PURPOSE OF REVIEW: To provide an overview of paraneoplastic autoimmune disorders presenting with various movement disorders. RECENT FINDINGS: The spectrum of paraneoplastic autoimmune disorders has been expanding with the discovery of new antibodies against cell surface and intracellular antigens. Many of these paraneoplastic autoimmune disorders manifest as a form of movement disorder. With the discovery of new neuronal antibodies, an increasing number of idiopathic or neurodegenerative movement disorders are now being reclassified as immune-mediated movement disorders...
October 13, 2017: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/29077387/anti-nmda-receptor-encephalitis-from-bench-to-clinic
#10
Arun Venkatesan, Krishma Adatia
NMDAR encephalitis is a common cause of autoimmune encephalitis, predominantly affecting young adults. Current data supports the idea that autoantibodies targeting NMDARs are responsible for disease pathogenesis. While these autoantibodies occur in the setting of underlying malignancy in approximately half of all patients, initiating factors for the autoimmune response in the remainder of patients are unclear. While there is increasing evidence supporting viral triggers such as herpes simplex encephalitis, this association and the mechanism of action have not yet been fully described...
November 7, 2017: ACS Chemical Neuroscience
https://www.readbyqxmd.com/read/29075658/improving-the-antibody-based-evaluation-of-autoimmune-encephalitis
#11
Lindsey McCracken, Junxian Zhang, Maxwell Greene, Anne Crivaro, Joyce Gonzalez, Malek Kamoun, Eric Lancaster
OBJECTIVE: We tested whether antibody screening samples of patients with suspected autoimmune encephalitis with additional research assays would improve the detection of autoimmune encephalitis compared with standard clinical testing alone. METHODS: We examined 731 samples (333 CSF, 182 sera, and 108 pairs) from a cohort of 623 patients who were tested for CNS autoantibodies by the University of Pennsylvania clinical laboratory over a 24-month period with cell-based assays (CBAs) on commercially obtained slides of fixed cells for antibodies to NMDA receptor (NMDAR), α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR), γ-aminobutyric acid-B receptor (GABABR), leucine-rich glioma-inactivated 1 (LGI1), contactin-associated protein-like 2 (Caspr2), and glutamic acid decarboxylase (GAD65)...
November 2017: Neurology® Neuroimmunology & Neuroinflammation
https://www.readbyqxmd.com/read/29073246/increased-serum-anti-n-methyl-d-aspartate-receptor-antibody-immunofluorescence-in-psychiatric-patients-with-past-catatonia
#12
Chin-Chuen Lin, Yi-Yung Hung, Meng-Chang Tsai, Tiao-Lai Huang
OBJECTIVE: Anti-N-methyl-D-aspartate receptor (NMDAR) antibody was thought to be the cause of anti-NMDAR encephalitis, with manifestations similar to catatonia and schizophrenia. Anti-NMDAR antibody in neuropsychiatric patients who had catatonia before were investigated in a follow-up evaluation. The intensity of antibody immunofluorescence was quantified and compared with healthy controls. METHOD: Nineteen patients (eight males and eleven females) agreed to be followed-up...
2017: PloS One
https://www.readbyqxmd.com/read/29065417/comparisons-between-psychiatric-symptoms-of-patients-with-anti-nmdar-encephalitis-and-new-onset-psychiatric-patients
#13
Jinxiang Wang, Bo Zhang, Manxue Zhang, Junming Chen, Hong Deng, Qiang Wang, Xueli Sun
BACKGROUND: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a potentially lethal autoimmune disease. Early diagnosis and immunotherapy can improve prognosis; however, early prominent psychiatric symptoms have led to misdiagnosis in numerous cases, delaying diagnosis and treatment. This study aimed to explore the clinical features and psychiatric symptoms of anti-NMDAR encephalitis and the association between antibody titers and psychiatric symptoms. METHODS: In this retrospective study, 43 patients with anti-NMDAR encephalitis and 70 new-onset psychiatric patients were enrolled...
October 24, 2017: Neuropsychobiology
https://www.readbyqxmd.com/read/29053906/serum-complement-levels-in-anti-n-methyl-d-aspartate-receptor-encephalitis
#14
Y Shu, C Chen, Y Chen, Y Xu, Y Chang, R Li, X Sun, L Peng, Z Lu, W Qiu
BACKGROUND AND PURPOSE: This study aimed to evaluate the relationship between serum complement and anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis. METHODS: Serum complement (C3, C4 and CH50), immunoglobulins (IgG, IgM and IgA) and C-reactive protein (CRP) were evaluated in 40 patients with anti-NMDAR encephalitis and 40 controls. Follow-up evaluations of 11 of the 40 patients with anti-NMDAR encephalitis were conducted 6 months after admission. Modified Rankin Scale (mRS) scores and clinical and cerebrospinal fluid parameters were evaluated in patients with anti-NMDAR encephalitis...
October 20, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29050165/-ovarian-tumor-associated-with-anti-n-methyl-d-aspartate-receptor-encephalitis-a-report-of-15-cases
#15
X M Li, H Y Jiang, Y F Wang, W Qiu, Y Wang, H T Wu
Objective: To summarize the clinical features of patients with ovarian tumor and anti-N-methyl-D-aspartate receptor(NMDAR) encephalitis, and to explore the influence of operation patterns on the prognosis. Methods: The clinical information of patients with ovarian tumor and anti-NMDAR encephalitis in The 3rd Affiliated Hospital of Sun Yat-Sen University and The Zhujiang Hospital of Southern Medical University were collected and analyzed. Results: There were 15 patients were enrolled in this study, with the average age of 24...
October 10, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29040795/case-presentation-of-anti-nmda-receptor-encephalitis-in-a-4-year-old-boy
#16
Daniel A Gbadero, Emmanuel O Adegbite, Jean-Baptist LePichon, Tina M Slusher
We report a case of a 4-year-old boy from Oyo, Nigeria, presenting with prolonged seizures and coma with the subsequent development of oro-lingual-facial dyskinesia with frequent tongue thrusting, dysconjugate gaze and choreoathetoid movements of the limbs because of autoimmune encephalitis consistent with anti-N-methyl-D-aspartate (anti-NMDAR) encephalitis.
October 6, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/29026836/anti-n-methyl-d-aspartate-receptor-encephalitis-that-aggravates-after-acinetobacter-baumannii-pneumonia-a-case-report
#17
Cheng C Wang, Da J Li, Yi Q Xia, Kai Liu
We report an atypical case of anti-N-methyl-D-aspartate receptor encephalitis (ANMDARE). A 27-year-old man diagnosed with ANMDARE received immunotherapy and had a good recovery. However, within one month, he developed severe status epilepticus and decreased level of conscience with new hyperpyrexia and dyspnea, and was admitted to the emergency intensive care unit. Acinetobacter baumanii were found in the sputum culture; and anti-NMDAR antibodies were positive (titer: 1/80) in the cerebrospinal fluid. Repeated immunotherapy was administered with antibacterial agents, and the patient recovered except for mild psychiatric sequelae...
September 16, 2017: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/29023630/the-hmgb1-is-increased-in-csf-of-patients-with-an-anti-nmdar-encephalitis
#18
P Ai, X Zhang, Z Xie, G Liu, X Liu, S Pan, H Wang
BACKGROUND: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an autoimmune disorder of the central nervous system (CNS). Interleukin (IL)-6 and IL-17A may play important roles in the pathogenesis of this disease. High-mobility group box protein 1 (HMGB1), a small but highly conserved ubiquitous protein, is recognized to be a potent innate inflammatory mediator that can activate the nuclear factor light chain enhancer of activated B cells and release cytokines such as IL-6 and IL-17A when released extracellularly...
October 12, 2017: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/28993875/suicidality-is-a-common-and-serious-feature-of-anti-n-methyl-d-aspartate-receptor-encephalitis
#19
Le Zhang, Josemir W Sander, Lan Zhang, Xin-Yue Jiang, Wei Wang, Kun Shuang, Ammar Taha Abdullah Abdulaziz, Meng-Qian Wu, Xiao-Sa Chi, Jin-Mei Li, Dong Zhou
We aimed to assess suicidality risk amongst people who had had anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. All people with a definitive diagnosis of anti-NMDAR encephalitis in West China Hospital between June 2012 and February 2017 were identified and their notes were retrospectively reviewed. Demographic and clinical characteristics and risk predictors for suicidality were summarized; those with suicidality were compared to those without. 17 of 133 people (13%) presented with suicidality symptoms: 7 (5%) with suicidal ideation; 8 (6%) who attempted suicide; and 2 (1...
December 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28986868/detection-of-nmdars-antibodies-in-encephalitis
#20
Matteo Gastaldi, Patrick Waters, Angela Vincent
There is a range of diseases of the brain that are associated with rapidly developing inflammation. These conditions are called encephalitis, and can be caused by infections, or autoimmune disorders when the subject's immune system reacts against host proteins. The most common form of autoimmune encephalitis is associated with antibodies against the NR1 subunit of the N-Methyl-D-Aspartate Receptor (anti-NMDAR-encephalitis). Antibody detection is important for diagnosis, and can be performed only with techniques that preserve the full tertiary structure (conformation) of the antigen...
2017: Methods in Molecular Biology
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