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Published on: January 9, 2018
Intrathecal Rituximab as a Rescue Therapy in Refractory Pure CSF Positive, Non-Teratomatous Type Anti-NMDAR
Parameswaran Krishnan1, Kurian Thomas1
1Department of Neurology, Indo American Hospital Institute of Brain and Spine, Vaikom, Kerala, India.
Abstract:
NMDAR antibody encephalitis is the most common autoimmune encephalitis characterized by a myriad of neuropsychiatric symptoms. It predominantly affects females and is associated with ovarian teratoma (58%). Nineteen percent do not respond to treatment and are left with serious neurological deficits. A subset of NMDAR encephalitis with antibody positivity in CSF alone without ovarian teratoma is often found to be refractory to treatment. We name them . We report two such cases who responded to intrathecal rituximab, to highlight a novel treatment as a rescue therapy to prevent long-term disability and improve clinical outcomes.
