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anti--NMDA Receptor Encephalitis

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https://www.readbyqxmd.com/read/30318435/mycophenolate-mofetil-azathioprine-and-methotrexate-usage-in-paediatric-anti-nmdar-encephalitis-a-systematic-literature-review
#1
REVIEW
Margherita Nosadini, Shekeeb S Mohammad, Irene Toldo, Stefano Sartori, Russell C Dale
BACKGROUND: Available data on mycophenolate mofetil (MMF), azathioprine (AZA) and methotrexate (MTX) for paediatric-onset anti-N-methyl-d-aspartate receptor encephalitis (anti-NMDARE) is limited. METHODS: Systematic literature review on patients treated with MMF/AZA/MTX for paediatric-onset anti-NMDARE, with focus on modes of use, efficacy and safety. RESULTS: 87 patients were included (age at onset median 11 years, range 0.8-18 years; 69% females)...
September 27, 2018: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/30305377/anti-nmdar-encephalitis-complicating-pregnancy
#2
Sabrina Kalam, Aravindhan Baheerathan, Cillian McNamara, Victoria Singh-Curry
Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis was first reported in 2005 in four patients with ovarian teratomas; there have been many further cases reported since the antigen for the NMDAR antibody was confirmed in 2007. Patients characteristically have a well-defined set of features, characterised by psychiatric disturbance, seizures and cognitive disturbance, followed by movement disorders, disorders of consciousness and dysautonomia. To date, 14 cases of NMDAR encephalitis have been described in the context of pregnancy...
October 10, 2018: Practical Neurology
https://www.readbyqxmd.com/read/30279081/transient-extreme-spindles-in-a-young-child-with-anti-nmdar-encephalitis-a-case-report
#3
Sachi Tokunaga, Minako Ide, Takehiro Ishihara, Takako Matsumoto, Toshiro Maihara, Takeo Kato
Anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis is a type of immune-mediated encephalitis, which is a new category of treatment-responsive paraneoplastic encephalitis. In patients with this disease, electroencephalography (EEG) shows non-specific findings, but recently, a unique EEG pattern, named the extreme delta brush, was detected in 40% of adult patients and was suggested to be specific to this type of encephalitis. Here, we describe a two-year-old boy with anti-NMDAR encephalitis, who presented with speech arrest and disturbances of gait and cognition several weeks after developing febrile convulsions...
September 29, 2018: Brain & Development
https://www.readbyqxmd.com/read/30253732/atypical-development-of-neurosyphilis-mimicking-limbic-encephalitis
#4
Karine Beiruti, Anan Abu Awad, Galina Keigler, Chen Hanna Ryder, Radi Shahien
A previously healthy 35-year-old man suffering from behavioral and mental deterioration for three months was referred to our facility. On admission, the patient was dysphasic and had tonic-clonic seizures. Neurological examination showed mental confusion, euphoric mood, mania, paranoia, and mild motor dysphasia. Magnetic resonance imaging (MRI) was performed twice but no abnormalities were revealed. His acute confusional state, elevated cerebrospinal fluid (CSF) protein, epileptic seizure and electroencephalogram showing intermittent frontal slowness were all suggestive of encephalitis...
September 26, 2018: International Journal of STD & AIDS
https://www.readbyqxmd.com/read/30247289/an-uncommon-presentation-of-a-primary-bone-tumor-anti-ampa-anti-%C3%AE-amino-3-hydroxy-5-methyl-4-isoxazolepropionic-acid-receptor-limbic-paraneoplastic-encephalitis-as-a-presenting-feature-of-ewing-sarcoma
#5
Daniel Koh, Theodore Lau, Evonne Teoh, Kenneth K Lau
Anti-AMPA (anti-α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid) receptor limbic encephalitis is a rare autoimmune syndrome. It can be associated with an underlying malignancy, such as lung, breast, or thymus. We are reporting a case of a 19-year-old patient who presented with a 2-week history of confusion and short-term memory loss. A magnetic resonance imaging of brain showed increased T2 hyperintensity within the hippocampi bilaterally. Cerebrospinal fluid analysis was positive for anti-AMPA receptor antibodies...
October 2018: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/30246558/analysis-of-relation-between-electroclinical-features-and-cerebrospinal-fluid-antibody-titers-in-patients-with-anti-nmdar-encephalitis
#6
Ailiang Miao, Mingyang Du, Lingling Wang, Jianqing Ge, Hengdong Lu, Haiyan Xu, Hongxing Liu, Chuanyong Yu, Caiyun Wu, Yuan Gao, Jintao Sun, Qi Shi, Xiaoshan Wang
PURPOSE: This study aimed to determine the relation between electroclinical features and cerebrospinal fluid (CSF) antibody titers in patients with anti- N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis. METHOD: Clinical symptoms and electroencephalography (EEG) at different stages were analyzed in 51 hospitalized patients with anti-NMDAR encephalitis. RESULTS: Behavioral changes were the initial symptoms in 90.9% (20/22) of female patients with high (1:10 or 1:32) CSF antibody titers...
September 24, 2018: Clinical EEG and Neuroscience: Official Journal of the EEG and Clinical Neuroscience Society (ENCS)
https://www.readbyqxmd.com/read/30217214/nivolumab-induced-encephalopathy-in-a-man-with-metastatic-renal-cell-cancer-a-case-report
#7
Jindřich Kopecký, Ondřej Kubeček, Tomáš Geryk, Birgita Slováčková, Petr Hoffmann, Miroslav Žiaran, Peter Priester
BACKGROUND: Great progress has recently been made in the treatment of metastatic renal cell carcinoma, including the introduction of nivolumab, an immune checkpoint inhibitor. Despite promising results, this treatment brings a completely new spectrum of adverse events, distinct from those experienced with small-molecule kinase inhibitors. Neurologic immune-related adverse events may be serious and potentially life-threatening complications requiring immediate immunosuppressive therapy...
September 15, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/30216211/the-effectiveness-of-phenobarbital-in-patients-with-refractory-status-epilepticus-undergoing-therapeutic-plasma-exchange
#8
Sheng-Nan Wang, Chun-Ping Gu, Guang-Hui Liu, Zhen-Zhou Lin, Ping Zheng, Su-Yue Pan, Shi-Ting Liu
This study aimed to elucidate the therapeutic concentration range of phenobarbital (PB) for adults, as well as the influence of therapeutic plasma exchange (TPE) on plasma concentration of PB. We retrospectively reviewed consecutive patients diagnosed with refractory status epileptic (RSE) and treated with a bolus injection of PB as well as TPE, admitted to our neurocritical care unit from November 2015 to October 2016. Continuous electroencephalographic monitoring was performed routinely for these patients...
November 7, 2018: Neuroreport
https://www.readbyqxmd.com/read/30210034/-progress-in-immunotherapy-for-children-with-anti-n-methyl-d-aspartate-receptor-encephalitis
#9
Zhan Zhang, Feng Fang
Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is an autoimmune encephalitis that was reported in recent years. At present, there remains no unified treatment regimen for the children and adolescents with this disease around the world. Immunotherapy is still the preferred way of treatment, mainly including first-line immunotherapy, second-line immunotherapy, and long-term immunotherapy. In recent years, some researchers have tried new immunosuppressants or modified immunotherapy regimens to improve the treatment outcome of the patients...
September 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/30186144/toxic-epidermal-necrolysis-in-a-patient-with-autoimmune-limbic-encephalitis-with-anti-glutamate-receptor-antibodies
#10
Keiko Hatano, Hideyuki Matsumoto, Akihiko Mitsutake, Junko Yoshimura, Aya Nomura, Sumihisa Imakado, Yukitoshi Takahashi, Hideji Hashida
We report on a 44-year-old woman who was diagnosed with toxic epidermal necrolysis (TEN) during the recovery phase from autoimmune limbic encephalitis with anti-glutamate receptor antibodies. Both, autoimmune limbic encephalitis and TEN are very rare diseases. The co-existence of the two diseases has not yet been reported. We speculate that the total of 18 drugs needed for the treatment of encephalitis might have increased the risk of TEN. Similar reports would be required to elucidate the pathophysiology of the co-existence...
May 2018: Case Reports in Neurology
https://www.readbyqxmd.com/read/30177907/cognitive-function-recovery-pattern-in-adult-patients-with-severe-anti-n-methyl-d-aspartate-receptor-encephalitis-a-longitudinal-study
#11
Zhongqin Chen, Dengchang Wu, Kang Wang, Benyan Luo
Objective: To observe the dynamic characteristics of cognitive function following early application of immunotherapy in adult patients with severe anti N-methyl D-aspartate receptor (anti-NMDAR) encephalitis. Methods: Serial neuropsychological assessments were performed at three sequential time points in five adult patients with severe anti-NMDAR encephalitis following early-initiated immunotherapy. The three sequential points were 1-2, 6, and 11-12 months after treatment. Five normal subjects without psychological or neurological diseases were assessed as a control group...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/30150348/anti-ampa-receptor-encephalitis-associated-with-medullary-thyroid-cancer
#12
Navira Samad, Jennifer Wong
AMPA receptor (AMPAR) antibodies are a group of recently discovered antibodies which target the neuronal synaptic proteins causing B-cell (immune) mediated neuronal damage, resulting in various neurologic syndromes depending on the area of central nervous system involvement. These syndromes are mostly reversible if treated early. Tumour association has been reported in up to 60% of cases in the most recent case series with lung, breast, ovarian cancers and thymomas being the most commonly associated malignancies with these antibodies...
August 27, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/30146304/human-autoantibodies-against-the-ampa-receptor-subunit-glua2-induce-receptor-reorganization-and-memory-dysfunction
#13
Holger Haselmann, Francesco Mannara, Christian Werner, Jesús Planagumà, Federico Miguez-Cabello, Lars Schmidl, Benedikt Grünewald, Mar Petit-Pedrol, Knut Kirmse, Joseph Classen, Fatih Demir, Nikolaj Klöcker, David Soto, Sören Doose, Josep Dalmau, Stefan Hallermann, Christian Geis
AMPA receptors are essential for fast excitatory transmission in the CNS. Autoantibodies to AMPA receptors have been identified in humans with autoimmune encephalitis and severe defects of hippocampal function. Here, combining electrophysiology and high-resolution imaging with neuronal culture preparations and passive-transfer models in wild-type and GluA1-knockout mice, we analyze how specific human autoantibodies against the AMPA receptor subunit GluA2 affect receptor function and composition, synaptic transmission, and plasticity...
October 10, 2018: Neuron
https://www.readbyqxmd.com/read/30133068/encephalitis-is-an-important-clinical-component-of-myelin-oligodendrocyte-glycoprotein-antibody-associated-demyelination-a-single-center-cohort-study-in-shanghai-china
#14
L Wang, J ZhangBao, L Zhou, Y Zhang, H Li, Y Li, Y Huang, M Wang, C Lu, J Lu, C Zhao, C Quan
BACKGROUND AND PURPOSE: Besides a distinct spectrum of demyelinating syndromes, encephalitis was observed in patients with myelin oligodendrocyte glycoprotein antibodies (MOG-abs). METHODS: The clinical records of 690 patients with idiopathic demyelinating diseases of the central nervous system seen in our center from June 2015 to December 2017 were retrospectively reviewed. All underwent serum aquaporin 4 antibody (AQP4-ab) and MOG-ab detection by cell-based assays as a routine diagnostic approach...
August 22, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/30130269/multistage-neurorehabilitation-of-an-adolescent-with-severe-anti-n-methyl-d-aspartate-receptor-encephalitis-a-case-report
#15
Velda X Han, Michelle W X Lee, Jeremy B Lin
We report on a 15-year-old girl with severe anti-N-methyl-D-aspartate receptor encephalitis who had initial poor prognostic factors. We delineate the unique challenges faced in the rehabilitation of our patient including sleep disruption and food aversion. After 20 months of hospitalization and intensive rehabilitation, there was a significant improvement in functional abilities and self-care skills. However, she had residual neurocognitive deficits, visual perceptual, and motor coordination difficulties that continued to improve after discharge, attesting to the need for long-term rehabilitation...
August 18, 2018: International Journal of Rehabilitation Research. Revue Internationale de Recherches de Réadaptation
https://www.readbyqxmd.com/read/30112069/clinical-diagnosis-and-treatment-of-pediatric-anti-n-methyl-d-aspartate-receptor-encephalitis-a-single-center-retrospective-study
#16
Yang Sai, Xiao Zhang, Mei Feng, Jingwen Tang, Hongmei Liao, Lihong Tan
The aim of the present retrospective study was to investigate the diagnosis, treatment and prognosis of pediatric anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis. A total of 23 pediatric patients with anti-NMDAR encephalitis were included in the present study. The clinical data, laboratory test results, imaging examination, treatment outcomes, and follow-up records were reviewed and analyzed. A total of 8 patients exhibited prodromal symptoms, including fever, cough, and vomiting. Clinical symptoms included epilepsy, convulsions, ataxia, coma, dyskinesia, personal behavior change and hallucinations...
August 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/30109465/anti-gaba-b-receptor-encephalitis-in-a-patient-with-gastric-adenocarcinoma
#17
Xiao-Tao Jia, Yanfang Pan, Zhengli Di, Naibing Gu, Zhiqin Liu, Yu-Ming Kang
Anti-γ-aminobutyric acid-B (GABAB ) receptor encephalitis is an autoimmune encephalitis associated with antibodies against neuronal cell surface antigens, which are primarily observed with small-cell lung cancer, melanoma, and thymoma. Here, we first report a case on the association between a relatively frequent cancer, gastric adenocarcinoma (GAC), and a rare GABAB receptor antibody limbic encephalitis. The patient was treated with immunotherapy and combined-drug chemotherapy, which were partially effective in terms of stabilizing the tumor and relieving neurological symptoms...
August 14, 2018: Neurological Sciences
https://www.readbyqxmd.com/read/30095300/two-case-reports-of-neuropsychological-outcomes-following-pediatric-anti-n-methyl-d-aspartate-receptor-autoimmune-encephalitis
#18
Natalia Moss, Christine L Petranovich, Lauren Parks, Andrea Sherwood
Anti-NMDAR autoimmune encephalitis is a rare neurological condition. Limited existing pediatric case studies have shown mild, but persisting, neuropsychological impairments. This report described neuropsychological functioning in two patients treated for anti-NMDAR autoimmune encephalitis. Patient A is a 16-year-old male (10 months after symptom onset) and Patient B is a 5-year-old female (45 months after symptom onset). Contrary to expectations, their cognitive profiles were largely intact, raising the possibility of minimal cognitive implications for some pediatric patients with this condition...
2018: Developmental Neuropsychology
https://www.readbyqxmd.com/read/30093243/autoimmune-encephalopathy-beyond-anti-nmdar-encephalitis-the-case-of-an-adolescent-male-with-antiacetylcholine-receptor-ganglionic-neuronal-antibody-encephalitis
#19
Ferdnand C Osuagwu, Sarah S Mohiuddin, Nasuh Malas
No abstract text is available yet for this article.
July 20, 2018: Psychosomatics
https://www.readbyqxmd.com/read/30090761/anti-nmdar-encephalitis-in-a-13-year-old-female-a-24-month-clinical-follow-up
#20
Eunsil Kim, Eu Gene Park, Jiwon Lee, Munhyang Lee, Jihye Kim, Jeehun Lee
Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a rare autoimmune disorder manifesting as seizures, movement disorders, and psychiatric changes. However, there have been few case reports concerning this disorder in South Korean children. The current case report describes a pediatric patient with anti-NMDAR encephalitis. A 13-year-old female patient developed clonic movements of the right arm followed by aphasia, paresthesia, and right-sided hemiparesis. The electroencephalogram (EEG) results indicated electroclinical seizures arising from the left temporal area...
June 2018: Journal of Epilepsy Research
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