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Anti-NMDA Encephalitis

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https://www.readbyqxmd.com/read/28979520/status-epilepticus-and-anti-nmda-receptor-encephalitis-after-resection-of-an-ovarian-teratoma
#1
Amritpal S Jandu, Peter M Odor, Steven D Vidgeon
Anti-N-methyl-D-aspartate receptor encephalitis is a recently recognised autoimmune, paraneoplastic syndrome that typically presents with psychiatric disturbance, reduced conscious level and seizures. The disorder has been previously associated with ovarian teratomas. We present the case of a 35-year-old female, with a previous surgical history for resection of an ovarian teratoma, who later developed status epilepticus and anti-N-methyl-D-aspartate receptor encephalitis requiring intensive care management...
November 2016: J Intensive Care Soc
https://www.readbyqxmd.com/read/28974594/an-unusual-case-of-refractory-status-epilepticus-in-a-young-lady-anti-nmda-receptor-encephalitis
#2
Ching Soong Khoo, Nurul Husna Zulkifli, Siti Soraya Ab Rahman
We describe a case of a young lady with anti-NMDA (N-methyl-D-aspartate) receptor encephalitis, who initially presented with status epilepticus. Her seizures and orofacial dyskinesia were refractory to four anticonvulsants. She received intravenous immunoglobulin and a left ovarian tumour (an associated feature) was resected. However, her outcome was poor because of delayed treatment, autonomic dysfunction and complications of prolonged hospitalisation. This case highlights the importance of an early recognition of this rare but increasingly recognised disease...
October 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28959704/cryptogenic-norse-its-distinctive-clinical-features-and-response-to-immunotherapy
#3
Takahiro Iizuka, Naomi Kanazawa, Juntaro Kaneko, Naomi Tominaga, Yutaka Nonoda, Atsuko Hara, Yuya Onozawa, Hiroki Asari, Takashi Hata, Junya Kaneko, Kenji Yoshida, Yoshihiro Sugiura, Yoshikazu Ugawa, Masashi Watanabe, Hitomi Tomita, Arifumi Kosakai, Atsushi Kaneko, Daisuke Ishima, Eiji Kitamura, Kazutoshi Nishiyama
OBJECTIVE: To report the distinctive clinical features of cryptogenic new-onset refractory status epilepticus (C-NORSE) and the C-NORSE score based on initial clinical assessments. METHODS: A retrospective study was conducted for 136 patients with clinically suspected autoimmune encephalitis who underwent testing for autoantibodies to neuronal surface antigens between January 1, 2007, and August 31, 2016. Eleven patients with C-NORSE were identified. Their clinical features were compared with those of 32 patients with anti-NMDA receptor encephalitis (NMDARE)...
November 2017: Neurology® Neuroimmunology & Neuroinflammation
https://www.readbyqxmd.com/read/28948076/peripheral-neuropathy-in-limbic-encephalitis-with-anti-glutamate-receptor-antibodies-case-report-and-systematic-literature-review
#4
Yi-Chia Wei, Chin-Chang Huang, Chi-Hung Liu, Hung-Chou Kuo, Jainn-Jim Lin
INTRODUCTION: Autoantibodies to the alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor and N-methyl-d-aspartate (NMDA) receptor are known to be the causes of autoimmune encephalitis particularly limbic encephalitis. The involvement of the peripheral nervous system is rarely reported. METHODS: We analyzed the serial nerve conduction studies of a previously reported case of anti-AMPA receptor encephalitis, who was presented with conscious disturbance and quadriplegia...
September 2017: Brain and Behavior
https://www.readbyqxmd.com/read/28932896/-update-on-anti-n-methyl-d-aspartate-receptor-encephalitis
#5
S Kovac, J Alferink, D Ahmetspahic, V Arolt, N Melzer
Autoimmune encephalitis is a group of autoimmune inflammatory disorders affecting both grey and white matter of the central nervous system. Encephalitis with autoantibodies against the N‑methyl-D-aspartate receptor (NMDA-R) is the most frequent autoimmune encephalitis syndrome presenting with a characteristic sequence of psychiatric and neurological symptoms. Treatment necessitates a close interdisciplinary cooperation. This article provides an update on the current knowledge on diagnostic standards, pathogenesis, and treatment strategies for anti-NMDA-R encephalitis from psychiatric and neurological perspectives...
September 20, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28930529/a-protocol-for-investigating-the-association-of-vaccination-and-anti-nmda-receptor-encephalitis
#6
Hsiuying Wang
Anti-N-methyl-D-aspartate (Anti-NMDA) receptor encephalitis is an acute autoimmune neurological disorder that can be triggered by virus, H1N1/tetanus/diphtheria/pertussis and polio vaccines or by presence of a tumor. The association between anti-NMDA receptor encephalitis and Japanese encephalitis vaccination was examined and a general protocol of phylogenetic method which details the steps and code and an example of its utility is provided. The approach used here is potentially useful for analyzing the relationship between vaccines and diseases...
January 1, 2018: Frontiers in Bioscience (Scholar Edition)
https://www.readbyqxmd.com/read/28905135/a-case-of-reversible-anti-nmda-receptor-encephalitis-neuropsychological-and-neuroradiological-features
#7
Carlotta Mutti, Federica Barocco, Lucia Zinno, Anna Negrotti, Marco Spallazzi, Giovanni Pavesi, Simona Gardini, Paolo Caffarra
Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is an autoimmune encephalitis mainly affecting young women. We report a case of a mild paraneoplastic anti-NMDAR encephalitis in a 31-year-old female with an ovarian immature teratoma. The patient exhibited a severe short-term episodic memory impairment and psychiatric symptoms. A detailed diagnostic work-up including complete clinical and laboratory examinations, neuropsychological assessments, and neuroradiological investigations has been done at the onset and during follow-up...
September 13, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28886955/successful-combined-targeting-of-b-and-plasma-cells-in-treatment-refractory-anti-nmdar-encephalitis
#8
Olafur Sveinsson, Mathias Granqvist, Yngve Forslin, Kaj Blennow, Henrik Zetterberg, Fredrik Piehl
We describe an extremely severe case of therapy refractory NMDA receptor encephalitis (NMDAe) in a 26-year-old woman. After rituximab, bilateral oophorectomy, repeated cycles of high dose methylprednisolone and plasma exchange, she received repeated cyclophosphamide, tocilizumab (interleukin-6 inhibitor) and finally bortezomib (plasma cell depleting drug) leading to remission after 204days in intensive care. Two years after disease onset her cognitive functions are still affected, but slowly improving and the cerebral atrophy has been partly reversed...
November 15, 2017: Journal of Neuroimmunology
https://www.readbyqxmd.com/read/28882707/functional-connectivity-of-large-scale-brain-networks-in-patients-with-anti-nmda-receptor-encephalitis-an-observational-study
#9
Michael Peer, Harald Prüss, Inbal Ben-Dayan, Friedemann Paul, Shahar Arzy, Carsten Finke
BACKGROUND: In anti-NMDA receptor (NMDAR) encephalitis, antibody-mediated dysfunction of NMDARs causes severe neuropsychiatric symptoms, including psychosis, memory deficits, and movement disorders. However, it remains elusive how antibody-mediated NMDAR dysfunction leads to these symptoms, and whether the symptoms arise from impairment in specific brain regions and the interactions between impaired regions. METHODS: In this observational study, we recruited 43 patients with anti-NMDAR encephalitis from a tertiary university hospital and 43 age-matched and sex-matched healthy controls without a history of neurological or psychiatric disorders, who were recruited from the general population of Berlin...
October 2017: Lancet Psychiatry
https://www.readbyqxmd.com/read/28853520/-anti-n-methyl-d-aspartate-nmda-encephalitis-the-israeli-pediatric-multi-center-experience
#10
Keren Politi, Dafna Marom, Shay Ashkenazi, Gilat Livni, Hadassa Goldberg, Avinoam Shuper, Tami Steinberg, Eli Lahat, Eli Haiman, Rachel Shtrausberg
Anti-N-methyl-D-aspartate (NMDA) encephalitis is a disorder characterized by acute neuro-psychiatric symptoms, appearing mostly after a recent febrile disease, with a gradual progressive course, associated with laboratory or radiologic evidence of active inflammation. Many of the patients will present with a continuous neuro-cognitive disorder which could lead to major morbidity and even mortality. It was recently reported that this disorder can present at childhood as a primary disease or as a secondary complication of herpes simplex infection...
August 2017: Harefuah
https://www.readbyqxmd.com/read/28829986/neurobiology-of-autoimmune-encephalitis
#11
REVIEW
Masaki Fukata, Norihiko Yokoi, Yuko Fukata
Autoimmune encephalitis presenting with amnesia, seizures, and psychosis is highly topical in basic and clinical neuroscience. Recent studies have identified numerous associated autoantibodies, targeting cell-surface synaptic proteins including neurotransmitter receptors (e.g. NMDA receptors (NMDARs)) and a secreted protein, LGI1. In vitro and in vivo analyses of the influence of the autoantibodies have begun to clarify their causal roles. Of particular interest is the generation of recombinant monoclonal antibodies from patients' B cells with anti-NMDAR encephalitis...
August 19, 2017: Current Opinion in Neurobiology
https://www.readbyqxmd.com/read/28777034/chronic-schizophrenia-later-diagnosed-with-anti-nmda-receptor-encephalitis-case-report-and-review-of-the-literature
#12
Meghan A Conroy, Thomas Finch, Tomer T Levin, Alexander E Merkler, Joseph Safdieh, Susan Samuels, Janna S Gordon Elliott
No abstract text is available yet for this article.
August 4, 2017: Clinical Schizophrenia & related Psychoses
https://www.readbyqxmd.com/read/28770118/new-onset-insomnia-in-a-pediatric-patient-a-case-of-anti-nmda-receptor-encephalitis
#13
Tamar N Goldberg, Michael F Cellucci
Anti-NMDAR encephalitis is becoming more widely recognized as a cause of encephalopathy in both adults and children. Certain clinical features such as mood lability, movement disorders, speech dysfunction, seizures, and autonomic instability in a pediatric patient should prompt immediate concern and evaluation for autoimmune encephalitis among providers. We present the case of a pediatric patient with anti-NMDAR encephalitis in which the symptom prompting medical evaluation was insomnia. Insomnia has not previously been emphasized in the literature as a presenting feature of this disease in children and has a broad differential...
2017: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/28738102/anti-nmda-receptor-encephalitis-presenting-as-a-primary-psychotic-disorder
#14
Michele A Nelson, Jeannie D Lochhead, Gerald A Maguire
No abstract text is available yet for this article.
August 2017: Annals of Clinical Psychiatry: Official Journal of the American Academy of Clinical Psychiatrists
https://www.readbyqxmd.com/read/28730861/comparative-outcomes-in-children-and-adults-with-anti-n-methyl-d-aspartate-anti-nmda-receptor-encephalitis
#15
Eliza Gordon-Lipkin, Anusha K Yeshokumar, Deanna Saylor, Ana Arenivas, John C Probasco
This study compared neurologic disability and adaptive function in children and adults >1 year following anti- N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis diagnosis. Retrospective record review identified 12 patients with anti-NMDAR encephalitis. At last follow-up, all surviving patients had "good" modified Rankin Score (0-2). Four children, 6 adults, and their families participated in a telephone interview. Median duration since diagnosis was similar for children (2.42 years, interquartile range 2...
October 2017: Journal of Child Neurology
https://www.readbyqxmd.com/read/28683723/case-report-anaesthetic-management-of-radical-gastrectomy-for-gastric-cancer-associated-with-anti-n-methyl-d-aspartate-receptor-encephalitis
#16
Lei Ding, Hongyu Tan, Ziyu Li, Jiafu Ji, Xuejun Song
BACKGROUND: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a rare neurological disorder that is caused by the production of antibodies against NMDARs. As many anaesthetic drugs interact with NMDARs and may worsen the disease and because the disease poses risks, such as cardiovascular events, hyperthermia and respiratory insufficiency, while under anaesthesia, administering anaesthesia to patients with this disorder is clinically challenging. CASE PRESENTATION: A 55-year-old man with gastric cancer associated with anti-NMDAR encephalitis who was diagnosed 8 months prior was admitted to Peking University Cancer Hospital for tumour resection...
July 6, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28680648/treating-refractory-post-herpetic-anti-n-methyl-d-aspartate-receptor-encephalitis-with-rituximab
#17
Christine Strippel, Constanze Mönig, Kristin S Golombeck, Andre Dik, Kathrin Bönte, Stjepana Kovac, Andreas Schulte-Mecklenbeck, Heinz Wiendl, Sven G Meuth, Andreas Johnen, Catharina C Gross, Nico Melzer
Herpes simplex virus-1 has been identified as the trigger factor in certain cases of NMDA-receptor autoimmune encephalitis. We report on a 67-year-old female patient, who was severely affected by post-herpetic NMDA-receptor autoimmune encephalitis. Her symptoms did not improve under methylprednisolone pulse therapy and plasma exchange under acyclovir prophylaxis. She received protein A immunoadsorption and a long-term immunosuppression with rituximab. Under treatment, activated T-cells as well as B- and plasma cells decreased in peripheral blood and cerebrospinal fluid, and anti-NMDA-R IgG titers in serum and cerebrospinal fluid declined with near complete cessation of intrathecal autoantibody synthesis...
July 2017: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/28650064/-a-new-case-of-psychotic-break-as-the-presenting-symptom-of-anti-nmda-receptor-encephalitis-treatment-from-a-neuropsychiatric-approach
#18
P Hernaez-Goni, P Luna-Lario, J Tirapu-Ustarroz
INTRODUCTION: Limbic encephalitis generated by anti-N-methyl D-aspartate (NMDA) receptor antibodies is a severe acute neurological condition that is more prevalent in young females and is associated with an underlying tumour. The appearance of severe initial psychiatric signs and symptoms and the fact that it is accompanied by emotional disorders and severe cognitive impairment make it necessary to reconsider the contributions of neuropsychiatry to the diagnosis, development and treatment of the disease, since these have received little attention from researchers to date...
July 1, 2017: Revista de Neurologia
https://www.readbyqxmd.com/read/28616386/extreme-delta-brush-evolving-into-status-epilepticus-in-a-patient-with-anti-nmda-encephalitis
#19
Aline Herlopian, Eric S Rosenthal, Catherine J Chu, Andrew J Cole, Aaron F Struck
Extreme delta brush (EDB) is an EEG pattern unique to anti-NMDA encephalitis. It is correlated with seizures and status epilepticus in patients who have a prolonged course of illness. The etiology of the underlying association between EDB and seizures is not understood. We present a patient with anti-NMDA encephalitis who developed status epilepticus evolving from the high frequency activity of the extreme delta brush. This case demonstrates that EDB is not only a marker for a greater propensity for seizures but also directly implicated in seizure generation...
2017: Epilepsy & Behavior Case Reports
https://www.readbyqxmd.com/read/28592819/spatial-and-temporal-boundaries-of-nmda-receptor-hypofunction-leading-to-schizophrenia
#20
Kazu Nakazawa, Vivek Jeevakumar, Kazuhito Nakao
The N-methyl-D-aspartate receptor hypofunction is one of the most prevalent models of schizophrenia. For example, healthy subjects treated with uncompetitive N-methyl-D-aspartate receptor antagonists elicit positive, negative, and cognitive-like symptoms of schizophrenia. Patients with anti-N-methyl-D-aspartate receptor encephalitis, which is likely caused by autoantibody-mediated down-regulation of cell surface N-methyl-D-aspartate receptors, often experience psychiatric symptoms similar to schizophrenia initially...
February 3, 2017: NPJ Schizophrenia
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