Anti-NMDA-receptor antibody encephalitis in infants

Purpose: Anti-N-methyl-d-aspartate (NMDA) receptor antibody encephalitis is an autoimmune disorder manifesting subacutely with prominent aberrant movements and psychiatric symptoms. The clinical course is one of progressive clinical deterioration that can be halted and often reversed by early diagno...

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Main Authors: Amr A. Matoq, Adam S. Rappoport, Yiting Yang, Jessica O'Babatunde, Rubina Bakerywala, Raj D. Sheth
Format: Article
Language:English
Published: Elsevier 2015-01-01
Series:Epilepsy and Behavior Case Reports
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2213323215000341
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author Amr A. Matoq
Adam S. Rappoport
Yiting Yang
Jessica O'Babatunde
Rubina Bakerywala
Raj D. Sheth
author_facet Amr A. Matoq
Adam S. Rappoport
Yiting Yang
Jessica O'Babatunde
Rubina Bakerywala
Raj D. Sheth
author_sort Amr A. Matoq
collection DOAJ
description Purpose: Anti-N-methyl-d-aspartate (NMDA) receptor antibody encephalitis is an autoimmune disorder manifesting subacutely with prominent aberrant movements and psychiatric symptoms. The clinical course is one of progressive clinical deterioration that can be halted and often reversed by early diagnosis and treatment. Patterns of presentation and etiology of anti-NMDA-receptor antibody encephalitis are dependent on age and can be challenging to recognize in very young children. Reports: Sequential clinical case observations of anti-NMDA-receptor antibody encephalitis presenting in very young children were examined over a year at a single tertiary pediatric institution. Cerebrospinal fluid confirmed anti-NMDA-receptor antibodies in two cases (a 21-month-old boy and a 29-month-old girl) that demonstrated either bizarre behavioral patterns or status epilepticus both associated with progressive deterioration. Once recognized, the clinical course was arrested and reversed by aggressive treatment with plasma exchange, immunoglobulin, and high dose IV steroids. Conclusion: Infants with anti-NMDA-receptor antibody encephalitis can present with frank seizures or seizure mimics. Regardless, prompt recognition and aggressive treatment of anti-NMDA-receptor antibody encephalitis, while challenging, can quickly arrest deterioration and hasten recovery, thereby, limiting neurological morbidity.
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spelling doaj.art-e4aa4ec8ece64d42804c0f945a4ac1c92022-12-22T01:35:11ZengElsevierEpilepsy and Behavior Case Reports2213-32322015-01-014C9910110.1016/j.ebcr.2015.07.005Anti-NMDA-receptor antibody encephalitis in infantsAmr A. Matoq0Adam S. Rappoport1Yiting Yang2Jessica O'Babatunde3Rubina Bakerywala4Raj D. Sheth5University of Florida & Wolfson Children Hospital, Jacksonville, FL, USANemours Children Health System, Jacksonville, FL, USANemours Children Health System, Jacksonville, FL, USAUniversity of Florida & Wolfson Children Hospital, Jacksonville, FL, USANemours Children Health System, Jacksonville, FL, USAUniversity of Florida & Wolfson Children Hospital, Jacksonville, FL, USAPurpose: Anti-N-methyl-d-aspartate (NMDA) receptor antibody encephalitis is an autoimmune disorder manifesting subacutely with prominent aberrant movements and psychiatric symptoms. The clinical course is one of progressive clinical deterioration that can be halted and often reversed by early diagnosis and treatment. Patterns of presentation and etiology of anti-NMDA-receptor antibody encephalitis are dependent on age and can be challenging to recognize in very young children. Reports: Sequential clinical case observations of anti-NMDA-receptor antibody encephalitis presenting in very young children were examined over a year at a single tertiary pediatric institution. Cerebrospinal fluid confirmed anti-NMDA-receptor antibodies in two cases (a 21-month-old boy and a 29-month-old girl) that demonstrated either bizarre behavioral patterns or status epilepticus both associated with progressive deterioration. Once recognized, the clinical course was arrested and reversed by aggressive treatment with plasma exchange, immunoglobulin, and high dose IV steroids. Conclusion: Infants with anti-NMDA-receptor antibody encephalitis can present with frank seizures or seizure mimics. Regardless, prompt recognition and aggressive treatment of anti-NMDA-receptor antibody encephalitis, while challenging, can quickly arrest deterioration and hasten recovery, thereby, limiting neurological morbidity.http://www.sciencedirect.com/science/article/pii/S2213323215000341Anti-NMDAREncephalitisChildParaneoplastic syndromePsychosisBehavioral outburst
spellingShingle Amr A. Matoq
Adam S. Rappoport
Yiting Yang
Jessica O'Babatunde
Rubina Bakerywala
Raj D. Sheth
Anti-NMDA-receptor antibody encephalitis in infants
Epilepsy and Behavior Case Reports
Anti-NMDAR
Encephalitis
Child
Paraneoplastic syndrome
Psychosis
Behavioral outburst
title Anti-NMDA-receptor antibody encephalitis in infants
title_full Anti-NMDA-receptor antibody encephalitis in infants
title_fullStr Anti-NMDA-receptor antibody encephalitis in infants
title_full_unstemmed Anti-NMDA-receptor antibody encephalitis in infants
title_short Anti-NMDA-receptor antibody encephalitis in infants
title_sort anti nmda receptor antibody encephalitis in infants
topic Anti-NMDAR
Encephalitis
Child
Paraneoplastic syndrome
Psychosis
Behavioral outburst
url http://www.sciencedirect.com/science/article/pii/S2213323215000341
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AT adamsrappoport antinmdareceptorantibodyencephalitisininfants
AT yitingyang antinmdareceptorantibodyencephalitisininfants
AT jessicaobabatunde antinmdareceptorantibodyencephalitisininfants
AT rubinabakerywala antinmdareceptorantibodyencephalitisininfants
AT rajdsheth antinmdareceptorantibodyencephalitisininfants