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Anti-N-methyl-D-aspartate receptor encephalitis

Katherine McIvor, Perry Moore
OBJECTIVE: Anti N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is an autoimmune disorder that was only fully discovered recently and neuropsychological outcome data remains sparse. We present the case of BA, a 19-year-old male, which illustrates the cognitive outcome in an untreated case over a time period of over 2½ years. METHOD: We conducted three cognitive assessments, including tests of memory and executive functioning, over this time period and considered the evidence for reliable change in memory function using the Wechsler Advanced Clinical Solutions (ACS) serial assessment package...
October 20, 2016: Clinical Neuropsychologist
David W Nauen
Anti-N-methyl-d-aspartate-type glutamate receptor autoimmune encephalitis can arise in the setting of ovarian teratoma and often responds to resection. When it occurs in the absence of tumor, failure to respond to treatment may be more likely, and affected patients often require intensive care. To further understand the mechanisms and potential management, we present findings from an autopsy conducted on a young woman who died of refractory autoimmune encephalitis of this type. Rituximab was administered 70 days before death, and both 37 and 14 days before death, CD19(+) lymphocytes were only 0...
September 22, 2016: Journal of Critical Care
Kantha Medepalli, Cody M Lee, Lauryn A Benninger, Jean M Elwing
OBJECTIVE: Anti-N-methyl-d-aspartate receptor encephalitis is a rare but emerging cause of autoimmune encephalitis. Our objective is to present a case of this rare disease while highlighting the importance of an aggressive search for underlying malignancy as well as the common mischaracterization of primary psychiatric illness that occurs in these patients. METHODS: A young Caucasian female with no known psychiatric history presented with acute onset of seizures and psychosis...
2016: SAGE Open Med Case Rep
Sook Hui Chaw, Li Lian Foo, Lucy Chan, Kang Kwong Wong, Suhailah Abdullah, Boon Kiong Lim
Anti-N-methyl-d-aspartate receptor encephalitis is a recently described neurological disorder and an increasingly recognized cause of psychosis, movement disorders and autonomic dysfunction. We report 20-year-old Chinese female who presented with generalized tonic-clonic seizures, recent memory loss, visual hallucinations and abnormal behavior. Anti-N-methyl-d-aspartate receptor encephalitis was diagnosed and a computed tomography scan of abdomen reviewed a left adnexal tumor. We describe the first such case report of a patient with anti-N-methyl-d-aspartate receptor encephalitis who was given a bilateral transversus abdominis plane block as the sole anesthetic for removal of ovarian tumor...
September 26, 2016: Revista Brasileira de Anestesiologia
Jean-Marie Beis, Morgane Renard
OBJECTIVE: Anti-NMDA (N-Methyl-D-Aspartate) receptor encephalitis (NMDA-E) is the second cause of autoimmune encephalitis in adults. The objectives of this presentation are to describe the main clinical elements and rehabilitation specificities. OBSERVATIONS: Three female inpatients (mean age: 25) present with moderate to severe behavioural and/or psychiatric disorders, seizures and presence of associated tumor in one patient. Presence of anti-NMDA antibodies in the cerebrospinal liquid confirmed diagnosis...
September 2016: Annals of Physical and Rehabilitation Medicine
Jacob Peacock, Idris Amin, Syed Ahmed
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Paolo C Mimbella, Monica Verduzco-Gutierrez, Michael J Irvine, Tomasz K Podobinski
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Shigemi Nagayama, Keiko Tanaka
Recently, the search for diagnostic antibody markers has drawn considerable attention in relation to autoimmune encephalitis. Among the antibody markers, the most frequently detected is the anti-N-methyl-D-aspartate receptor (NMDAR)antibody. Patients with this antibody develop characteristic clinical features. This disease tends to affect young women, and starts with psychiatric symptoms followed by seizures, involuntary movements, autonomic failure, and respiratory failure. Nearly half of these female patients have ovarian teratoma...
September 2016: Brain and Nerve, Shinkei Kenkyū No Shinpo
Atsurou Yamada, Nobuhiro Miyachi, Toshiyasu Miura, Masako Suzuki, Norio Watanabe, Tatsuo Akechi
INTRODUCTION: Post-infectious encephalitis/encephalopathy is a neurological syndrome that sometimes develops following common viral or bacterial infections. The most common form is acute disseminated encephalomyelitis (ADEM). ADEM is a demyelinating disease of the central nervous system that typically presents as a monophasic disorder associated with multifocal neurologic symptoms and encephalitis. Anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis is another type of severe autoimmune disorder, characterized by seizures, movement disorders and psychiatric symptoms...
2016: SpringerPlus
Qi Huang, Yuan Wu, Rongfa Qin, Xing Wei, Meigang Ma
Anti-N-Methyl-D-Aspartate receptor (NMDAR) encephalitis is an acute neurological disorder affecting children and adults. We aimed to compare the clinical characteristics, treatments, and outcomes between children and adults with anti-NMDAR encephalitis and to assess the probable risk factors. In this observational study, patients who tested positive for anti-NMDAR antibody in the cerebrospinal fluid were enrolled. The patients were divided into children and adults group on the basis of age (whether <16 or not)...
September 15, 2016: Journal of Neurology
Bi-Chun Duan, Wen-Chin Weng, Kuang-Lin Lin, Lee Chin Wong, Sung-Tse Li, Mei-Hsin Hsu, Jainn-Jim Lin, Pi-Chaun Fan, Ming-I Lin, Nan-Chang Chiu, Yu-Ching Lin, Huei-Shyong Wang, Kun-Long Hung, Wang-Tso Lee
Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is one of the most common autoimmune encephalitis that presents with a wide variety of movement disorders. The purpose of our study is to review the manifestations and duration of movement disorders in different ages with NMDAR encephalitis.A retrospective cohort of 28 patients (20 females and 8 males) with positive cerebrospinal fluid (CSF) anti-NMDAR antibody in a 5-year period from major hospitals in Taiwan was enrolled. They were categorized into 3 age groups: 7 patients were ≤10 years, 14 patients were 10 to 18 years, and 7 patients were >18 years...
September 2016: Medicine (Baltimore)
Xueping Chen, Jin-Mei Li, Fan Liu, Qiong Wang, Dong Zhou, Xiaohui Lai
Anti-N-methyl-D-aspartate receptor encephalitis (anti-NMDAR encephalitis) is the most common type of immune-mediated encephalitis. This study aimed to assess the incidence and mortality of anti-NMDAR encephalitis in intensive care unit (ICU) to evaluate the clinical manifestations, laboratory findings, managements and outcomes, and to compare these characteristics with patients with non-anti-NMDAR encephalitis admitted to ICU. Patients admitted to the neurological ICU with suspected encephalitis were included between January 1, 2012 and July 31, 2015...
September 12, 2016: Neurological Sciences
Daiki Yamanaka, Takashi Kawano, Hiroki Tateiwa, Hideki Iwata, Fabricio M Locatelli, Masataka Yokoyama
BACKGROUND: Anti-N-methyl-d-aspartate receptor (NMDA-R) encephalitis is a recently identified but increasingly recognized autoimmune paraneoplastic disease. Because these patients present complex neuropsychiatric symptoms due to NMDA-R dysfunction, the optimal methods of sedation/anesthesia remain controversial. Here, we present animal experiment data, along with a related case report, implying the safe and effective use of dexmedetomidine in patients with anti-NMDA-R encephalitis. FINDINGS: (1) Animal experiment: in order to investigate whether dexmedetomidine may interfere with NMDA-R activity, an NMDA antagonist (MK-801) model in rats was used to simulate anti-NMDA-R encephalitis...
2016: SpringerPlus
M Schou, S G Sæther, K Borowski, B Teegen, D Kondziella, W Stoecker, A Vaaler, S K Reitan
BACKGROUND: Autoimmune encephalitis associated with anti-neuronal antibodies may be challenging to distinguish from primary psychiatric disorders. The significance of anti-neuronal antibodies in psychiatric patients without clear evidence of autoimmune encephalitis is unknown. We investigated the serum prevalence of six anti-neuronal autoantibodies in a cohort of unselected patients admitted to acute psychiatric care. METHOD: Serum was drawn from 925 patients admitted to acute psychiatric in-patient care...
September 9, 2016: Psychological Medicine
Adrija Hajra, Dhrubajyoti Bandyopadhyay
No abstract text is available yet for this article.
April 2016: Journal of Pediatric Neurosciences
Margaret Rozier, Denise Morita, Marta King
BACKGROUND: Anti-N-methyl-D-aspartate receptor encephalitis is an autoimmune disorder characterized by behavioral changes, dyskinesia, and autonomic instability. PATIENT DESCRIPTION: We describe a 14-year-old girl who initially presented with acute behavioral changes and seizures and who over a 2-week period developed high fever, tachycardia, and elevated blood pressures. RESULTS: Because she received multiple medications including anticonvulsants and a neuroleptic, our patient was initially diagnosed with neuroleptic malignant syndrome, a disorder characterized by autonomic dysfunction, hyperthermia, muscle rigidity, and mental status changes usually caused by the use of a neuroleptic agent...
October 2016: Pediatric Neurology
Roger Kelsey Halbert
Anti-N-methyl-D-aspartate receptor encephalitis is an autoimmune syndrome that presents with personality changes, autonomic dysfunction, and neurologic deterioration. Most patients with this syndrome progress from psychosis to seizure to catatonia, often associated with abnormal movements, autonomic instability, and hypoventilation. First-line treatment constitutes resection of the associated neoplasm, corticosteroids, intravenous immunoglobulin, and plasma exchange. Second-line treatment includes rituximab and cyclophosphamide...
October 2016: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
Jessica L Gough, Jan Coebergh, Brunda Chandra, Ramin Nilforooshan
Autoimmune encephalitis is a poorly understood condition that can present with a combination of neurological and psychiatric symptoms, either of which may predominate. There are many autoantibodies associated with a variety of clinical syndromes - anti-N-Methyl-D-Aspartate receptor (NMDAR) is the commonest. Currently, the most widely used therapy is prompt plasmapheresis and steroid treatment (and tumour resection if indicated), followed by second line immunosuppression if this fails. Given the growing awareness of autoimmune encephalitis as an entity, it is increasingly important that we consider it as a potential diagnosis in order to provide timely, effective treatment...
August 16, 2016: World Journal of Clinical Cases
Étienne de Montmollin, Sophie Demeret, Noëlle Brulé, Marie Conrad, Frédéric Dailler, Nicolas Lerolle, Jean-Christophe Navellou, Carole Schwebel, Mikaël Alves, Martin Cour, Nicolas Engrand, Jean-Marie Tonnelier, Eric Maury, Stéphane Ruckly, Géraldine Picard, Véronique Rogemond, Éric Magalhaes, Tarek Sharshar, Jean-François Timsit, Jérôme Honnorat, Romain Sonneville
RATIONALE: Encephalitis due to anti-N-methyl-D-aspartate receptor (NMDAR) antibodies is the leading cause of immune-mediated encephalitis. There is limited data on intensive care unit (ICU) management of these patients. OBJECTIVES: To identify prognostic factors of good neurologic outcome in patients admitted to an ICU with anti-NMDAR encephalitis. METHODS: Observational multicenter study of all consecutive adult patients diagnosed with anti-NMDAR encephalitis, admitted to an ICU between 2008 and 2014...
August 23, 2016: American Journal of Respiratory and Critical Care Medicine
Gemma L McKeon, James G Scott, Donna M Spooner, Alexander E Ryan, Stefan Blum, David Gillis, Daman Langguth, Gail A Robinson
BACKGROUND: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a recently described life-threatening autoimmune disorder associated with a characteristic multi-stage neuropsychiatric syndrome. Although it is known that the majority of patients experience neuropsychological disturbance post-treatment, some aspects of the cognitive profile remain unclear. METHODS: This study sought to investigate patterns of cognitive functioning in a sample of anti-NMDAR encephalitis patients...
September 2016: Journal of the International Neuropsychological Society: JINS
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