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Multifocal Stroke Complicating Anti-NMDA Receptor Encephalitis
Zina H Stavitsky1, Colin H Nguyen2, James Martin Johnston2
1Department of Pediatrics, Oregon Health Sciences University, Portland, Oregon, USA.
Abstract:
Anti-N-methyl-D-aspartate receptor encephalitis (NMDARE) is an autoimmune form of encephalitis, first described in 2005 and now recognized as among the more common causes of encephalitis. While NMDARE can result in permanent neurologic deficits or even mortality, the prognosis in children is generally more favorable; 75-85% of children and teenagers achieve a full or substantial recovery. We describe here a preadolescent female, whose course of NMDARE was complicated by a unilateral stroke, resulting in permanent deficits. The imaging characteristics suggest a vascular (thrombotic) etiology. To our knowledge, this is the first report of stroke in the setting of NMDARE.
Insights
Anti-N-methyl-D-aspartate receptor encephalitis (NMDARE) can cause severe deficits, but children usually recover well. This case report details a rare instance of a child experiencing a stroke complicating NMDARE, leading to permanent neurological damage.
Area of Science:
- Neuroscience
- Immunology
- Neurology
Background:
- Anti-N-methyl-D-aspartate receptor encephalitis (NMDARE) is a significant autoimmune neurological disorder.
- While NMDARE prognosis is generally favorable in pediatric patients, complications can occur.
- Stroke is not a commonly reported complication of NMDARE.
Observation:
- A preadolescent female diagnosed with NMDARE experienced a stroke during her illness.
- The stroke was unilateral and resulted in permanent neurological deficits.
- Imaging suggested a thrombotic vascular cause for the stroke.
Findings:
- This case represents the first documented occurrence of stroke in a patient with NMDARE.
- The findings highlight a potential, previously unreported complication of NMDARE.
Implications:
- Understanding the link between NMDARE and stroke is crucial for comprehensive patient management.
- This case may prompt further research into the vascular complications of autoimmune encephalitis.
- Early recognition and management of potential thrombotic events in NMDARE patients could improve outcomes.
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