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Anti-N-methyl-D-aspartate receptor encephalitis

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https://www.readbyqxmd.com/read/29774053/postherpes-simplex-encephalitis-a-case-series-of-viral-triggered-autoimmunity-synaptic-autoantibodies-and-response-to-therapy
#1
Harry Alexopoulos, Sofia Akrivou, Sotiria Mastroyanni, Maria Antonopoulou, Argirios Dinopoulos, Melpo Giorgi, Kostas Konstantinou, Evangelos Kouremenos, Maria Lariou, Dimitrios Naoumis, Efterpi Pavlidou, Evaggelos Pavlou, Konstantinos Voudris, Panayotis Vlachoyiannopoulos, Marinos C Dalakas
Background: Recent evidence suggests that patients with herpes simplex virus (HSV) encephalitis may relapse because of autoimmunity against the N-methyl-D-aspartate receptor (NMDAR). We present a case series of post-HSV relapsing encephalopathy associated with antibodies to central nervous system (CNS) synaptic antigens. Patient/Methods: Sera and cerebrospinal fluid (CSF) from five patients with HSV encephalitis who relapsed after antiviral therapy were tested for anti-NMDAR, gamma-aminobutyric acid b receptor (GABAbR), α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR), Leucine-rich, glioma inactivated 1 (LGI1), anti -contactin-associated protein-like 2 (CASPR2) and dipeptidyl-peptidase-like protein-6 (DDPX) antibodies using cell-based assays...
2018: Therapeutic Advances in Neurological Disorders
https://www.readbyqxmd.com/read/29761122/bortezomib-treatment-for-severe-refractory-anti-nmda-receptor-encephalitis
#2
Yong-Won Shin, Soon-Tae Lee, Tae-Joon Kim, Jin-Sun Jun, Kon Chu
Objective: To evaluate the therapeutic potential of bortezomib, a proteasome inhibitor that target plasma cells, in order to revive stalled recovery in patients with anti- N -methyl-d-aspartate (NMDA) receptor encephalitis who remain bedridden even after aggressive immunotherapy. Methods: We consecutively enrolled patients with anti-NMDA receptor encephalitis who remained bedridden after first-line immunotherapy (steroids and intravenous immunoglobulin), second-line immunotherapy (rituximab), and tocilizumab treatment, and treated them with subcutaneous bortezomib...
May 2018: Annals of Clinical and Translational Neurology
https://www.readbyqxmd.com/read/29742610/18f-fdg-pet-ct-in-anti-nmda-receptor-encephalitis-typical-pattern-and-follow-up
#3
Abdenasser Moubtakir, Sébastien Dejust, François Godard, Leila Messaoud, David Morland
We report the case of a 28-year-old woman presenting behavior disorders of subacute onset. She was referred in our institution for a suspicion of limbic encephalitis. F-FDG PET/CT did not show any mesiotemporal abnormality but depicted a decreased uptake of bilateral parietal and occipital lobes. This atypical pattern was compatible with an anti-N-methyl-D-aspartate receptor encephalitis that was later confirmed.
April 30, 2018: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29735495/anaesthetic-management-of-a-patient-with-a-unique-combination-of-anti-n-methyl-d-aspartate-receptor-encephalitis-and-stiff-person-syndrome
#4
Mohammad Hadi Gharedaghi, Arjang Khorasani, Nebojsa Nick Knezevic, Farzad Ebrahimi
Stiff-person syndrome (SPS) and anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis are rare paraneoplastic syndromes caused by antibodies that target the central nervous system. Here, we describe a 26-year-old woman who presented with psychosis, amnesia, rigidity and fever. After extensive diagnostic and laboratory workup, she was diagnosed with an ovarian teratoma which was causing the symptoms of anti-NMDAR encephalitis and SPS. The patient was successfully treated with laparoscopic removal of the ovarian tumour under general anaesthesia...
May 7, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29734104/late-onset-anti-n-methyl-d-aspartate-receptor-encephalitis-in-china
#5
Le Zhang, Xu Liu, Xin-Yue Jiang, Yun-Hui Wang, Jin-Mei Li, Dong Zhou
PURPOSE: This study aimed to summarize the clinical characteristics and outcome of late-onset anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis in China. METHOD: All cases of people with a definitive diagnosis of anti-NMDAR encephalitis in West China Hospital between June 2012 and April 2017 were retrospectively reviewed. The demographics, clinical characteristics, and outcome of those patients (age≥45years old) were summarized. Comparisons were conducted between older (≥45years old) and younger (18-44years old) adults...
May 4, 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29724875/unusual-case-of-anti-n-methyl-d-aspartic-acid-receptor-nmda-r-encephalitis-and-autoimmune-polyglandular-syndrome-aps
#6
Simona Frunza-Stefan, Hilary B Whitlatch, Gautam G Rao, Rana Malek
Anti-N-methyl-D-aspartic acid-receptor (NMDA-R) encephalitis is a novel disease discovered within the past 10 years. It is an autoimmune disease (AD) that has been associated with other ADs, such as Graves' disease. However, association with autoimmune polyglandular syndromes (APS) has not been previously described. A 58-year-old woman presented with altered mental status and an 8-month history of weight loss, apathy and somnolence. Laboratory evaluation confirmed Graves' disease with thyrotoxicosis and type 1 diabetes mellitus...
May 2, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29703768/long-term-neuropsychological-outcome-following-pediatric-anti-nmdar-encephalitis
#7
Marienke A A M de Bruijn, Femke K Aarsen, Marielle P van Oosterhout, Marieke M van der Knoop, Coriene E Catsman-Berrevoets, Marco W J Schreurs, Danielle E M Bastiaansen, Peter A E Sillevis Smitt, Rinze F Neuteboom, Maarten J Titulaer
OBJECTIVE: To provide detailed long-term outcome data of children and adolescents following pediatric anti- N -methyl-d-aspartate receptor (anti-NMDAR) encephalitis, to identify neuropsychological impairments, and to evaluate the influence of these factors on quality of life (QoL). METHODS: All Dutch children diagnosed with anti-NMDAR encephalitis were identified. Patients currently aged 4 years or older were included in the follow-up study, consisting of a visit to our clinic for a detailed interview and a standardized neuropsychological assessment...
April 27, 2018: Neurology
https://www.readbyqxmd.com/read/29698873/clinical-significance-of-igm-and-iga-class-anti-nmdar-antibodies-in-herpes-simplex-encephalitis
#8
Gabriel Westman, Azita Sohrabian, Elisabeth Aurelius, Clas Ahlm, Silvia Schliamser, Fredrik Sund, Marie Studahl, Johan Rönnelid
BACKGROUND: Herpes simplex encephalitis (HSE) is a devastating disease, often leaving patients with severe disabilities. It has been shown that IgG anti-N-methyl-d-aspartate receptor (NMDAR) antibodies appear in approximately 25% of HSE patients and could be associated with impaired recovery of cognitive performance. OBJECTIVES: To characterize the prevalence of IgM and IgA anti-NMDAR antibodies in HSE patients, in relation to subsequent development of IgG anti-NMDAR and correlation to cognitive performance...
April 10, 2018: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/29651625/clinical-characteristics-and-prognosis-of-severe-anti-n-methyl-d-aspartate-receptor-encephalitis-patients
#9
Yan Zhang, Gang Liu, Mengdi Jiang, Weibi Chen, Yanbo He, Yingying Su
BACKGROUND AND PURPOSE: Data concerning the characteristics and duration of the critical manifestations, treatment response, and long-term outcomes of severe anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis patients compared to those of non-severe patients are limited. This observational study was performed to explore the clinical characteristics and long-term outcomes of severe anti-NMDAR encephalitis patients. METHODS: According to their characteristics on admission to the neurology intensive care unit, patients with anti-NMDAR encephalitis were divided into a severe group and a non-severe group...
April 12, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29627783/anti-n-methyl-d-aspartate-receptor-encephalitis-relapse-in-the-brainstem
#10
Yuya Kobayashi, Shunichi Sato, Ken Takasone, Ryota Takamatsu
No abstract text is available yet for this article.
April 7, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29617708/a-systematic-review-of-the-neuropsychological-sequelae-of-people-diagnosed-with-anti-n-methyl-d-aspartate-receptor-encephalitis-in-the-acute-and-chronic-phases
#11
Della C M Nicolle, Jennifer L Moses
Objective: A systematic review was conducted to investigate the emerging cognitive profile for people diagnosed with anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis. Method: Ten papers met the review criteria including five neuropsychological case studies and five case series; three of the 10 studies used matched controls. The cognitive functioning of 54 participants (46 female: eight male) was studied. Paper quality assessment was undertaken and outcomes summarized...
March 31, 2018: Archives of Clinical Neuropsychology: the Official Journal of the National Academy of Neuropsychologists
https://www.readbyqxmd.com/read/29607915/-a-case-of-limbic-encephalitis-associated-with-sj%C3%A3-gren-s-syndrome-mimicking-anti-n-methyl-d-aspartate-receptor-encephalitis
#12
Kenji Yoshimura, Rie Kanki, Satoshi Nakano
A 25-year-old woman in her 37 weeks and 5 days pregnant presented with abnormal behavior and memory impairment following a high fever. Her manifestations were diagnosed as limbic encephalitis, and she delivered a baby by Cesarean section. In the operation, bilateral ovarian tumors were found and resected, though they were revealed as non-teratoma afterward. After operation, she became agitated, and started to present oral dyskinesia, intractable systemic myoclonus, central hypoventilation, and autonomic manifestations such as labile blood pressure, but her symptoms responded well to immunotherapy...
March 31, 2018: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/29605275/magnetic-resonance-imaging-and-positron-emission-tomography-in-anti-nmda-receptor-encephalitis-a-systematic-review
#13
REVIEW
Stephen Bacchi, Kyle Franke, Dasith Wewegama, Edward Needham, Sandy Patel, David Menon
Due to a variety of clinical manifestations anti-N-methyl-d-aspartate (NMDA) receptor encephalitis may be difficult to diagnose. Magnetic resonance imaging (MRI) may be used as a component of the workup for encephalopathy. However, the use of MRI in anti-NMDA encephalitis is complicated by wide-ranging reports regarding the frequency of normal MRI findings in this disease. Positron emission tomography (PET) is a modality of imaging that may assess functional rather than structural disturbances. Therefore, this review was conducted to summarise published studies regarding the use of MRI and PET in the diagnosis of anti-NMDA receptor encephalitis...
March 28, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29599011/anti-n-methyl-d-aspartate-receptor-encephalitis-in-children-incidence-and-experience-in-hong-kong
#14
Alvin Chi-Chung Ho, Sophelia Hoi-Shan Chan, Eric Chan, Sheila Suet-Na Wong, Sharon Tsui-Hang Fung, Sharon Wan-Wah Cherk, Eva Lai-Wah Fung, Kam-Hung Ma, Kwing-Wan Tsui, Eric Kin-Cheong Yau, Virginia Chun-Nei Wong
AIM: The study aims to analyze the incidence, clinical features, investigation findings and treatment outcomes of anti-N-methyl-d-aspartate receptor encephalitis in children from Hong Kong. METHOD: A retrospective study was carried out on paediatric patients diagnosed with anti-NMDAR encephalitis in Hong Kong from January 2009 to December 2015. RESULTS: Fifteen patients (67% female, 93% Chinese) were identified over seven years and the estimated incidence in Hong Kong was 2...
March 26, 2018: Brain & Development
https://www.readbyqxmd.com/read/29572931/genetic-predisposition-in-anti-lgi1-and-anti-nmda-receptor-encephalitis
#15
Stefanie H Mueller, Anna Färber, Harald Prüss, Nico Melzer, Kristin S Golombeck, Tania Kümpfel, Franziska Thaler, Martin Elisak, Jan Lewerenz, Max Kaufmann, Kurt-Wolfram Sühs, Marius Ringelstein, Christoph Kellinghaus, Christian G Bien, Andrea Kraft, Uwe K Zettl, Sven Ehrlich, Robert Handreka, Kevin Rostásy, Florian Then Bergh, Jürgen H Faiss, Wolfgang Lieb, Andre Franke, Gregor Kuhlenbäumer, Klaus-Peter Wandinger, Frank Leypoldt
We performed a genome-wide association study in 1,194 controls and 150 patients with anti-N-methyl-D-aspartate receptor (anti-NMDAR, n = 96) or anti-leucine-rich glioma-inactivated1 (anti-LGI1, n = 54) autoimmune encephalitis. Anti-LGI1 encephalitis was highly associated with 27 single-nucleotide polymorphisms (SNPs) in the HLA-II region (leading SNP rs2858870 p = 1.22 × 10-17 , OR = 13.66 [7.50-24.87]). Potential associations, below genome-wide significance, were found with rs72961463 close to the doublecortin-like kinase 2 gene (DCLK2) and rs62110161 in a cluster of zinc-finger genes...
April 2018: Annals of Neurology
https://www.readbyqxmd.com/read/29567651/brain-mri-characteristics-of-patients-with-anti-n-methyl-d-aspartate-receptor-encephalitis-and-their-associations-with-2-year-clinical-outcome
#16
T Zhang, Y Duan, J Ye, W Xu, N Shu, C Wang, K Li, Y Liu
BACKGROUND AND PURPOSE: Anti- N -methyl-D-aspertate receptor encephalitis is an autoimmune-mediated disease without specific brain MRI features. Our aim was to investigate the brain MR imaging characteristics of anti- N -methyl-D-aspartate receptor encephalitis and their associations with clinical outcome at a 2-year follow-up. MATERIALS AND METHODS: We enrolled 53 patients with anti- N -methyl-D-aspartate receptor encephalitis and performed 2-year follow-up. Brain MRIs were acquired for all patients at the onset phase...
March 22, 2018: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29549218/clinical-and-pathogenic-significance-of-igg-iga-and-igm-antibodies-against-the-nmda-receptor
#17
Makoto Hara, Eugenia Martinez-Hernandez, Helena Ariño, Thais Armangué, Marianna Spatola, Mar Petit-Pedrol, Albert Saiz, Myrna R Rosenfeld, Francesc Graus, Josep Dalmau
OBJECTIVE: To determine the frequency and clinical relevance of immunoglobulin (Ig)G, IgA, and IgM N -methyl-d-aspartate receptor (NMDAR) antibodies in several diseases, and whether the IgG antibodies occur in disorders other than anti-NMDAR encephalitis. METHODS: Evaluation of IgG, IgA, and IgM NMDAR antibodies in serum of 300 patients with anti-NMDAR encephalitis, stroke, dementia, schizophrenia, or seronegative autoimmune encephalitis. Antibodies and their effect on cultured neurons were examined with cell-based assays and brain and live neuronal immunostaining...
April 17, 2018: Neurology
https://www.readbyqxmd.com/read/29535092/ovarian-teratoma-associated-with-anti-nmda-n-methyl-d-aspartate-receptor-encephalitis
#18
Nellihela Leel, Hemanshoo S Thakkar, David Drake, Nordeen Bouhadiba
Anti-N-methyl D-aspartate receptor (NMDAR) encephalitis is a paraneoplastic, immune-mediated encephalopathy with a known association with ovarian teratomas. We present the first case in the UK of a 7-year-old patient presenting with this condition. Having been previously fit and healthy, the patient presented with an acute onset of cognitive disturbances. The initial suspicion was that of an infective encephalopathy; however, the lumbar puncture results were negative. Electroencephalography reported diffuse background slowing, supporting a diagnosis of encephalopathy...
March 13, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29523295/molecular-hypotheses-to-explain-the-shared-pathways-and-underlying-pathobiological-causes-in-catatonia-and-in-catatonic-presentations-in-neuropsychiatric-disorders
#19
E M Peter-Ross
The pathobiological causes, the shared cellular and molecular pathways in catatonia and in catatonic presentation in neuropsychiatric disorders are yet to be determined. The hypotheses in this paper have been deduced from the latest scientific research findings and clinical observations of patients with genetic disorders, behavioral phenotypes and other family members suffering mental disorders. The first hypothesis postulates that catatonia and the heterogeneity of catatonic signs and symptoms involve nucleolar dysfunction arising from abnormalities of the brain-specific, non-coding micro-RNA, SNORD115 genes (either duplications or deletions) which result in pathobiological dysfunction of various combinations in the downstream pathways (possibly along with other genes in these shared pathways)...
April 2018: Medical Hypotheses
https://www.readbyqxmd.com/read/29520252/management-of-refractory-orofacial-dyskinesia-caused-by-anti-n-methyl-d-aspartate-receptor-encephalitis-using-botulinum-toxin
#20
Feixia Zheng, Xiuyun Ye, Xulai Shi, Neha Devi Poonit, Zhongdong Lin
The use of botulinum neurotoxin serotype A (BoNT-A) injections for the treatment of orofacial dyskinesia secondary to anti- N -methyl-d-aspartate receptor (NMDAR) encephalitis is rarely reported. Here, we report a case of an urgent, successful management of severe orofacial dyskinesia in an 8-year-old girl with anti-NMDAR encephalitis using BoNT-A injection. The patient presented with de novo unilateral paroxysmal movement disorder progressing to generalized dystonia and repetitive orofacial dyskinesia. Diagnosis was confirmed by the presence of NMDAR antibodies in serum and cerebrospinal fluid...
2018: Frontiers in Neurology
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