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Anti-N-methyl-D-aspartate receptor encephalitis

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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
#1
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
#2
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/29110638/application-of-the-2016-diagnostic-approach-for-autoimmune-encephalitis-from-lancet-neurology-to-chinese-patients
#3
Lin Li, Lin Sun, Rong Du, Yuanchu Zheng, Feifei Dai, Qiuying Ma, Jiawei Wang
BACKGROUND: A unified clinical approach to diagnose autoimmune encephalitis was published in Lancet Neurology in 2016. Purpose of our study is to examine the feasibility and reasonability of the 2016 "A clinical approach to diagnosis of autoimmune encephalitis" in China with a retrospective study. METHODS: We retrospectively collected 95 cases of autoimmune encephalitis and non autoimmune encephalitis cases with detailed clinical data from Beijing Tongren Hospital and the China National Knowledge Infrastructure (CNKI)...
November 6, 2017: BMC Neurology
https://www.readbyqxmd.com/read/29103423/autoimmune-epilepsies
#4
Anusha K Yeshokumar, Carlos A Pardo
Autoimmune epilepsies describe clinical syndromes wherein the immune system is suspected to be involved in the pathogenesis of seizures or as a mechanism for neuronal injury following seizures. These diseases typically affect otherwise healthy children and are characterized by explosive onset of focal seizures, encephalopathy, cognitive deterioration, or other focal neurological deficits, or all of these. Traditional neurological diagnostics lack sensitivity and specificity in the diagnosis of autoimmune epilepsies, and results must be considered in the clinical context...
August 2017: Seminars in Pediatric Neurology
https://www.readbyqxmd.com/read/29101253/superficial-white-matter-damage-in-anti-nmda-receptor-encephalitis
#5
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
#6
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
#7
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/29073246/increased-serum-anti-n-methyl-d-aspartate-receptor-antibody-immunofluorescence-in-psychiatric-patients-with-past-catatonia
#8
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
#9
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
#10
Yaqing Shu, Chen Chen, Yin Chen, Yue Xu, Yanyu Chang, Rui Li, Xiaobo Sun, Lisheng Peng, Zhengqi Lu, Wei Qiu
BACKGROUND: This study aimed to evaluate the relationship between serum complement and anti-NMDAR encephalitis. METHODS: Serum complement (C3, C4, CH50), immunoglobulins (IgG, IgM, and IgA) and C-reactive protein (CRP) were evaluated in 40 anti-NMDAR encephalitis patients, and 40 controls. Follow-up evaluations of 11 out of the 40 anti-NMDAR encephalitis patients were conducted 6 months after admission. Modified Rankin scale (mRS) scores and clinical and cerebrospinal fluid (CSF) parameters were evaluated in anti-NMDAR encephalitis patients...
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
#11
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
#12
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
#13
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
#14
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
#15
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...
October 9, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28986868/detection-of-nmdars-antibodies-in-encephalitis
#16
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
https://www.readbyqxmd.com/read/28979520/status-epilepticus-and-anti-nmda-receptor-encephalitis-after-resection-of-an-ovarian-teratoma
#17
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
#18
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/28972277/high-sensitivity-and-specificity-in-proposed-clinical-diagnostic-criteria-for-anti-n-methyl-d-aspartate-receptor-encephalitis
#19
Alvin C C Ho, Shekeeb S Mohammad, Sekhar C Pillai, Esther Tantsis, Hannah Jones, Reena Ho, Ming Lim, Yael Hacohen, Angela Vincent, Russell C Dale
AIM: To determine the validity of the proposed clinical diagnostic criteria for anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis in paediatric patients. METHOD: The diagnostic criteria for anti-NMDAR encephalitis proposed by Graus et al. (2016) use clinical features and conventional investigations to facilitate early immunotherapy before antibody status is available. The criteria are satisfied if patients develop four out of six symptom groups within 3 months, together with at least one abnormal investigation (electroencephalography/cerebrospinal fluid) and reasonable exclusion of other disorders...
October 3, 2017: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/28948076/peripheral-neuropathy-in-limbic-encephalitis-with-anti-glutamate-receptor-antibodies-case-report-and-systematic-literature-review
#20
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
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