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Anti-NMDAR encephalitis: A single-center, longitudinal study in China
Xiaolu Xu1, Qiang Lu1, Yan Huang1
1From the Department of Neurology (X.X., Q.L., Y.H., S.F., L.Z., J.Y., X.Y., H.R., Y.Z., B.P., L.C., H.G.), Department of Gynecology and Obstetrics (D.S., Y.D.), Department of Emergency (H.Z.), and Department of Psychology (Y.J.), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; and Center of Neuroscience (L.C.), Chinese Academy of Medical Sciences.
This study on anti-NMDA receptor encephalitis in China found psychosis and seizures are common, with low neoplasm rates. Effective immunotherapy leads to favorable outcomes despite relapses.
Area of Science:
- Neurology
- Immunology
- Neuroimmunology
Background:
- Anti-NMDA receptor (NMDAR) encephalitis is a severe autoimmune neurological disorder.
- Understanding its clinical spectrum and treatment outcomes in diverse populations is crucial.
Purpose of the Study:
- To detail the clinical characteristics, immunotherapy approaches, and long-term prognosis of NMDAR encephalitis patients in China.
- To identify factors influencing long-term outcomes in this cohort.
Main Methods:
- A prospective, single-center study involving 220 patients diagnosed with NMDAR encephalitis between 2011 and 2017.
- Clinical data, treatment regimens, and follow-up outcomes were collected and analyzed.
Main Results:
- Psychosis (82.7%) and seizures (80.9%) were the most frequent presentations.
- Nineteen percent of patients had neoplasms, primarily ovarian teratomas in females.
- 94.1% improved within 12 months, with 92.7% achieving favorable outcomes (mRS ≤2), despite 17.3% experiencing relapses.
Conclusions:
- Chinese patients frequently exhibit psychosis and seizures but rarely have underlying neoplasms.
- First-line immunotherapy is effective for acute management, and combined long-term immunotherapy improves overall prognosis.
- Relapses are common but manageable, with most patients achieving good long-term outcomes.
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