Early multidisciplinary intensive-care therapy can improve outcome of severe anti-NMDA-receptor encephalitis presenting with extreme delta brush
Anti-N-methyl-D-aspartate receptor encephalitis (Anti-NMDARE) is a synaptic autoimmune encephalitis syndrome mainly affecting young females. An underlying tumor, most commonly ovarian teratomas in young females, may indicate a paraneoplastic syndrome. Prognostic factors of the clinical course of dis...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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De Gruyter
2019-10-01
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| Series: | Translational Neuroscience |
| Subjects: | |
| Online Access: | https://doi.org/10.1515/tnsci-2019-0039 |
| _version_ | 1818719108605149184 |
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| author | Schneider R. Brüne M. Breuer TG. Börnke C. Gold R. Juckel G. |
| author_facet | Schneider R. Brüne M. Breuer TG. Börnke C. Gold R. Juckel G. |
| author_sort | Schneider R. |
| collection | DOAJ |
| description | Anti-N-methyl-D-aspartate receptor encephalitis (Anti-NMDARE) is a synaptic autoimmune encephalitis syndrome mainly affecting young females. An underlying tumor, most commonly ovarian teratomas in young females, may indicate a paraneoplastic syndrome. Prognostic factors of the clinical course of disease and outcome play a central role in view of early administration of second-line immunotherapy and intensive-care therapy. We report a case of severe Anti-NMDARE associated with unfavorable predictors including an extreme delta brush (EDB) electroencephalographic-pattern and high anti-NMDAR-antibody titers in the cerebral spinal fluid (CSF), which necessitated the admission to an intensive care unit. In spite of the poor prognosis, the patient completely recovered; we attribute this to an early escalation to second-line immunotherapy with rituximab and multidisciplinary intensive-care therapy. The present case underlines the relevance of multidisciplinary management for individuals with Anti-NMDARE. |
| first_indexed | 2024-12-17T20:01:42Z |
| format | Article |
| id | doaj.art-ffd989b07ce74ccdaf890339fa87e1a1 |
| institution | Directory Open Access Journal |
| issn | 2081-6936 |
| language | English |
| last_indexed | 2024-12-17T20:01:42Z |
| publishDate | 2019-10-01 |
| publisher | De Gruyter |
| record_format | Article |
| series | Translational Neuroscience |
| spelling | doaj.art-ffd989b07ce74ccdaf890339fa87e1a12022-12-21T21:34:28ZengDe GruyterTranslational Neuroscience2081-69362019-10-0110124124310.1515/tnsci-2019-0039tnsci-2019-0039Early multidisciplinary intensive-care therapy can improve outcome of severe anti-NMDA-receptor encephalitis presenting with extreme delta brushSchneider R.0Brüne M.1Breuer TG.2Börnke C.3Gold R.4Juckel G.5Department of Neurology, St. Josef Hospital, Ruhr University Bochum, Bochum, GermanyDepartment of Psychiatry, Psychotherapy, and Preventive Medicine, Ruhr University Bochum, Bochum, GermanyDepartment of Medicine I, St Josef-Hospital, Ruhr-University Bochum, Bochum, GermanyDepartment of Neurology, St. Josef Hospital, Ruhr University Bochum, Bochum, GermanyDepartment of Neurology, St. Josef Hospital, Ruhr University Bochum, Bochum, GermanyDepartment of Psychiatry, Psychotherapy, and Preventive Medicine, Ruhr University Bochum, Bochum, GermanyAnti-N-methyl-D-aspartate receptor encephalitis (Anti-NMDARE) is a synaptic autoimmune encephalitis syndrome mainly affecting young females. An underlying tumor, most commonly ovarian teratomas in young females, may indicate a paraneoplastic syndrome. Prognostic factors of the clinical course of disease and outcome play a central role in view of early administration of second-line immunotherapy and intensive-care therapy. We report a case of severe Anti-NMDARE associated with unfavorable predictors including an extreme delta brush (EDB) electroencephalographic-pattern and high anti-NMDAR-antibody titers in the cerebral spinal fluid (CSF), which necessitated the admission to an intensive care unit. In spite of the poor prognosis, the patient completely recovered; we attribute this to an early escalation to second-line immunotherapy with rituximab and multidisciplinary intensive-care therapy. The present case underlines the relevance of multidisciplinary management for individuals with Anti-NMDARE.https://doi.org/10.1515/tnsci-2019-0039anti-nmda receptor encephalitisdelta brushpsychosisepileptic seizures - catatoniaimmunotherapyintensive care |
| spellingShingle | Schneider R. Brüne M. Breuer TG. Börnke C. Gold R. Juckel G. Early multidisciplinary intensive-care therapy can improve outcome of severe anti-NMDA-receptor encephalitis presenting with extreme delta brush Translational Neuroscience anti-nmda receptor encephalitis delta brush psychosis epileptic seizures - catatonia immunotherapy intensive care |
| title | Early multidisciplinary intensive-care therapy can improve outcome of severe anti-NMDA-receptor encephalitis presenting with extreme delta brush |
| title_full | Early multidisciplinary intensive-care therapy can improve outcome of severe anti-NMDA-receptor encephalitis presenting with extreme delta brush |
| title_fullStr | Early multidisciplinary intensive-care therapy can improve outcome of severe anti-NMDA-receptor encephalitis presenting with extreme delta brush |
| title_full_unstemmed | Early multidisciplinary intensive-care therapy can improve outcome of severe anti-NMDA-receptor encephalitis presenting with extreme delta brush |
| title_short | Early multidisciplinary intensive-care therapy can improve outcome of severe anti-NMDA-receptor encephalitis presenting with extreme delta brush |
| title_sort | early multidisciplinary intensive care therapy can improve outcome of severe anti nmda receptor encephalitis presenting with extreme delta brush |
| topic | anti-nmda receptor encephalitis delta brush psychosis epileptic seizures - catatonia immunotherapy intensive care |
| url | https://doi.org/10.1515/tnsci-2019-0039 |
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