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NMDA encephalitis

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https://www.readbyqxmd.com/read/29785583/the-effect-of-delayed-anti-nmdar-encephalitis-recognition-on-disease-outcome
#1
Vlatko Sulentic, Zeljka Petelin Gadze, Filip Derke, Marija Santini, Danira Bazadona, Sibila Nankovic
Anti-NMDA receptor encephalitis is an acute form of brain inflammation that is potentially lethal but has a high probability for recovery with treatment. Although the clinical picture of anti-NMDAR encephalitis is usually recognizable due to its relatively well-known symptoms, the disorder can sometimes present itself in an unpredictable and atypical way. In this case report, we wish to present the influence of different delay times prior to the establishment of diagnosis. Thus, our first patient was diagnosed with anti-NMDAR encephalitis 4 years after the initial symptoms, the second one after 8 years, and the third one after 13 months...
May 21, 2018: Journal of Neurovirology
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/29759996/pearls-oy-sters-relapse-of-anti-nmda-receptor-encephalitis-after-prior-first-and-second-line-immunotherapy
#3
Sharon Chiang, Tanu Garg, Austin Hu, Hitha Amin, Alfredo Davalos-Balderas, Isabel Alfradique-Dunham, Corey E Goldsmith
No abstract text is available yet for this article.
May 15, 2018: Neurology
https://www.readbyqxmd.com/read/29742610/18f-fdg-pet-ct-in-anti-nmda-receptor-encephalitis-typical-pattern-and-follow-up
#4
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/29739177/anesthesia-management-in-a-case-of-turner-syndrome-with-anti-nmda-limbic-encephalitis-and-multiple-co-morbidities-for-repair-of-fracture-femur
#5
Bhavna Gupta, Munisha Agarwal, Rohan Sharma, Vandana Saith
No abstract text is available yet for this article.
May 9, 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29738958/predictive-values-and-specificity-of-electroencephalographic-findings-in-autoimmune-encephalitis-diagnosis
#6
Chusak Limotai, Chayaporn Denlertchaikul, Abhinbhen W Saraya, Suda Jirasakuldej
OBJECTIVE: Early diagnosis of autoimmune encephalitis (AE) to not delay treatment is challenging but needed in practice. Most previous evidences of electroencephalographic (EEG) findings in AE were derived from descriptive studies. Given paucity of evidence of specific EEG findings to help with early diagnosis of AE, this study aimed to ascertain specific EEG findings and assess their predictive values in diagnosis of AE. METHODS: We included all cases with AE in our institution from January 2013 to June 2017...
May 5, 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
#7
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/29718831/generalized-and-lateralized-rhythmic-patterns
#8
Sarah E Schmitt
The relationship between generalized and lateralized rhythmic delta activity (RDA) and seizures is more ambiguous than the relationship between periodic discharges and seizures. Although frontally predominant generalized RDA is not associated with seizures, occipitally predominant RDA may be associated with the absence of seizures. Lateralized RDA seems to be more strongly associated with the presence of seizure activity. Appropriate recognition of generalized RDA and lateralized rhythmic delta activity may be confounded by benign etiologies of RDA, such as phi rhythm, slow alpha variant, subclinical rhythmic electrographic discharges of adults, or hyperventilation-induced high-amplitude rhythmic slowing...
May 2018: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/29718139/ion-channels-in-eeg-isolating-channel-dysfunction-in-nmda-receptor-antibody-encephalitis
#9
Mkael Symmonds, Catherine H Moran, M Isabel Leite, Camilla Buckley, Sarosh R Irani, Klaas Enno Stephan, Karl J Friston, Rosalyn J Moran
Neurological and psychiatric practice frequently lack diagnostic probes that can assess mechanisms of neuronal communication non-invasively in humans. In N-methyl-d-aspartate (NMDA) receptor antibody encephalitis, functional molecular assays are particularly important given the presence of NMDA antibodies in healthy populations, the multifarious symptomology and the lack of radiological signs. Recent advances in biophysical modelling techniques suggest that inferring cellular-level properties of neural circuits from macroscopic measures of brain activity is possible...
April 30, 2018: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/29629396/anti-nmda-receptor-encephalitis-and-nonencephalitic-hsv-1-infection
#10
Amy Salovin, Jason Glanzman, Kylie Roslin, Thais Armangue, David R Lynch, Jessica A Panzer
Objective: To determine whether there is an association between nonencephalitic herpes simplex virus 1 (HSV-1) infection and anti-NMDA receptor encephalitis (anti-NMDARE). Methods: Antibody testing was performed using samples from 2 cohorts in a case-control observational study. The cohort "Philadelphia" included 16 serum samples of pediatric anti-NMDARE cases and 42 age-matched controls with other neuroinflammatory disorders studied at the Children's Hospital of Philadelphia and University of Pennsylvania...
July 2018: Neurology® Neuroimmunology & Neuroinflammation
https://www.readbyqxmd.com/read/29628174/early-identification-of-anti-nmda-receptor-encephalitis-presenting-cerebral-lesions-in-unconventional-locations-on-magnetic-resonance-imaging
#11
Weihe Zhang, Lei Cui, Wei Wang, Yujuan Jiao, Yeqiong Zhang, Jinsong Jiao
To facilitate the diagnosis of anti-NMDAR encephalitis presenting with brain lesions in unconventional locations (BLUL) on MRI, we retrospectively analyzed forty-five Chinese patients. Eighteen (40.0%) of their MRI initially exhibited one or more BLUL. These locations predominantly included cerebral gray matter (cortex, basal ganglia and thalamus), as well as white matter and brainstem. Due to these BLUL, thirteen (72.2%) patients were originally misdiagnosed with other diseases and developed poor clinical and imaging outcomes...
March 29, 2018: Journal of Neuroimmunology
https://www.readbyqxmd.com/read/29620091/nmda-receptor-antibody-encephalitis-presenting-with-enhancing-lesion-and-seizures
#12
Michael H Rosenbloom, Melissa K Samuelsson, Michael E Brogan, Teresa A Tran-Lim
No abstract text is available yet for this article.
October 2017: Neurology. Clinical Practice
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
#13
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
#14
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
#15
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...
June 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29593838/b-cell-based-therapies-in-cns-autoimmunity-differentiating-cd19-and-cd20-as-therapeutic-targets
#16
REVIEW
Thomas G Forsthuber, Daniel M Cimbora, John Nolan Ratchford, Eliezer Katz, Olaf Stüve
Increasing recognition of the role of B cells in the adaptive immune response makes B cells an important therapeutic target in autoimmunity. Numerous current and developmental immunotherapies target B cells for elimination through recognition of cell-surface proteins expressed specifically on B cells, in particular CD19 and CD20. Similarities and differences in the function and expression of these two molecules predict some shared, and some distinct, pharmacological effects of agents targeting CD19 versus CD20, potentially leading to differences in the clinical safety and efficacy of such agents...
2018: Therapeutic Advances in Neurological Disorders
https://www.readbyqxmd.com/read/29588384/autoimmune-encephalitis-nmdar-antibody-in-a-patient-receiving-chronic-post-transplant-immunosuppression
#17
Anna Randall, Saif Huda, Anu Jacob, Andrew J Larner
Autoimmune encephalitis associated with antibodies (Abs) directed against the synaptic ligand-gated ion channel NMDA receptor (NMDAR) was first described as a paraneoplastic disorder in association with ovarian teratoma. Other forms of neoplasia have subsequently been reported although many patients do not have a tumour. Tumour removal, where applicable, and immunotherapy form the mainstays of treatment. We present a patient who developed NMDAR-Ab encephalitis despite being chronically immunosuppressed following organ transplantation, and who was eventually found to have an occult malignancy in the form of non-Hodgkin's lymphoma...
March 27, 2018: Practical Neurology
https://www.readbyqxmd.com/read/29580710/extreme-delta-with-or-without-brushes-a-potential-surrogate-marker-of-disease-activity-in-anti-nmda-receptor-encephalitis
#18
Claude Steriade, Stephen Hantus, Ahsan N V Moosa, Alexander D Rae-Grant
OBJECTIVE: Anti-NMDA receptor encephalitis (NMDARE) may not respond to first line immunotherapy. Biomarkers to track disease course and guide escalation of immunotherapy are needed. We describe the evolution of EEG in four patients with NMDARE requiring prolonged intensive care. METHODS: Within a database of 121 patients with immune-mediated neurological disorders, ten with NMDARE were retrospectively identified. Four patients did not respond to first line immunotherapy...
March 10, 2018: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/29572931/genetic-predisposition-in-anti-lgi1-and-anti-nmda-receptor-encephalitis
#19
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/29549218/clinical-and-pathogenic-significance-of-igg-iga-and-igm-antibodies-against-the-nmda-receptor
#20
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
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