Long-Term Outcome of Pediatric Patients with Anti-NMDA Receptor Encephalitis in a Single Center
Pei-Yu Wu1, Ching-Shiang Chi1, Chi-Ren Tsai1
1Division of Pediatric Neurology, Children's Medical Center, Taichung Veterans General Hospital, 1650, Taiwan Boulevard Sec. 4, Taichung 407, Taiwan.
Insights
Prompt treatment of anti-N-methyl-D-aspartate (NMDA) receptor encephalitis in children leads to favorable outcomes. Early recognition and first-line therapies significantly improve neurological recovery in pediatric patients with this autoimmune condition.
Area of Science:
- Neurology
- Pediatrics
- Immunology
Background:
- Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is a prevalent autoimmune condition in children.
- Prompt treatment is associated with a high likelihood of recovery.
Purpose of the Study:
- To analyze the clinical characteristics and long-term outcomes of pediatric patients diagnosed with anti-NMDA receptor encephalitis.
- To evaluate the effectiveness of early recognition and treatment strategies.
Main Methods:
- A retrospective study was conducted on 11 children with confirmed anti-NMDA receptor encephalitis.
- Data collected included clinical features, diagnostic tests, treatments administered, and patient outcomes over a median follow-up of 3.5 years.
Main Results:
- The median age of onset was 7.9 years, with a female predominance (72.7%).
- Behavioral changes were the most common initial presentation (72.7%), followed by seizures (27.3%).
- Most patients received immunotherapy (90.1%), and 90% achieved a modified Rankin Scale score of ≤ 2, indicating favorable neurological outcomes.
Conclusions:
- Early identification of anti-NMDA receptor encephalitis through clinical presentation and ancillary tests is crucial.
- Prompt initiation of first-line treatments results in favorable neurological outcomes for pediatric patients.
Background:
Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is the most common autoimmune encephalitis in children. There is a high probability of recovery if treated promptly. We aimed to analyze the clinical features and long-term outcomes of pediatric patients with anti-NMDA receptor encephalitis.
Method:
We conducted a retrospective study with definite diagnoses of anti-NMDA receptor encephalitis in 11 children treated in a tertiary referral center between March 2012 and March 2022. Clinical features, ancillary tests, treatment, and outcomes were reviewed.
Results:
The median age at disease onset was 7.9 years. There were eight females (72.7%) and three males (27.3%). Three (27.3%) patients initially presented with focal and/or generalized seizures and eight (72.7%) with behavioral change. Seven patients (63.6%) revealed normal brain MRI scans. Seven (63.6%) had abnormal EEG results. Ten patients (90.1%) received intravenous immunoglobulin, corticosteroid, and/or plasmapheresis. After a median follow-up duration of 3.5 years, one patient was lost to follow-up at the acute stage, nine (90%) had an mRS ≤ 2, and only one had an mRS of 3.
Conclusions:
With the early recognition of anti-NMDA receptor encephalitis based on its clinical features and ancillary tests, we were able to treat patients promptly with first-line treatment and achieve favorable neurological outcomes.
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