Early electro-clinical features may contribute to diagnosis of the anti-NMDA receptor encephalitis in children

Gitiaux, Cyril; Simonnet, H; Eisermann, Monika; Leunen, Dorothée; Dulac, Olivier; Nabbout, Rima; Chevignard, Mathilde; Honnorat, Jérôme; Gataullina, Svetlana; Musset, Lucile; Scalais, Emmanuel; Gauthier, Agnès; Hully, Marie; Boddaert, Nathalie; Kuchenbuch, Mathieu; Desguerre, Isabelle; Kamińska, Anna

doi:10.1016/j.clinph.2013.05.023

Cited by 71 publications

(59 citation statements)

References 28 publications

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“…53 Recognizing this established progression of specific symptoms and a lack of neuroimaging findings is essential to prospectively consider the diagnosis in the appropriate clinical setting, particularly when patients demonstrate characteristic electroencephalogram findings. 57 When brain MR imaging abnormalities are present, these T2-FLAIR hyperintense lesions can typically demonstrate mild transient cortical enhancement without restricted diffusion or hemorrhage (Fig 4). 3,14,53 When brain MR imaging findings are absent but the clinical findings suggest the possibility of an auto- immune encephalitis, brain FDG-PET imaging may be indicated, especially early in the disease process if clinical suspicion for autoimmune encephalitis is high, because it appears to be a more sensitive imaging technique for detecting temporal lobe abnormalities with normal brain MR imaging findings.…”

Section: N-methyl D-aspartate Receptormentioning

confidence: 99%

Autoimmune Encephalitis: Pathophysiology and Imaging Review of an Overlooked Diagnosis

Kelley¹,

Patel²,

Marin³

et al. 2017

AJNR Am J Neuroradiol

246

192

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SUMMARY: Autoimmune encephalitis is a relatively new category of immune-mediated disease involving the central nervous system that demonstrates a widely variable spectrum of clinical presentations, ranging from the relatively mild or insidious onset of cognitive impairment to more complex forms of encephalopathy with refractory seizure. Due to its diverse clinical features, which can mimic a variety of other pathologic processes, autoimmune encephalitis presents a diagnostic challenge to clinicians. Imaging findings in patients with these disorders can also be quite variable, but recognizing characteristic findings within limbic structures suggestive of autoimmune encephalitis can be a key step in alerting clinicians to the potential diagnosis and ensuring a prompt and appropriate clinical work-up. In this article, we review antibody-mediated encephalitis and its various subtypes with a specific emphasis on the role of neuroimaging in the diagnostic work-up. ABBREVIATIONS:

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Section: N-methyl D-aspartate Receptormentioning

confidence: 99%

Autoimmune Encephalitis: Pathophysiology and Imaging Review of an Overlooked Diagnosis

Kelley¹,

Patel²,

Marin³

et al. 2017

AJNR Am J Neuroradiol

246

192

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“…Extreme delta brushes in childhood were described in only a few studies [6,10,11]. In one pediatric series, the frequency of this EEG pattern was only 5% [10].…”

Section: Discussionmentioning

confidence: 99%

Extreme Delta Brushes in Pediatric Anti-N-Methyl-DAspartate Receptor Encephalitis

Montenegro¹,

Lizcano²,

Cendes³

et al. 2015

J Neurol Neurosci

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Anti-N-Methyl-D-Aspartate receptor (NMDAR) encephalitis is probably the most common paraneoplastic encephalitis. In children, seizures, behavioral disturbances and abnormal movements are the most frequent symptoms. Electroencephalogram is abnormal in most patients. We report a child with anti-NMDAR encephalitis presenting extreme delta brushes in the EEG. This new EEG feature is described in patients with anti-NMDAR encephalitis, mostly adults. The identification of this EEG pattern may guide to an early diagnosis and treatment of anti-NMDAR encephalitis.

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“…[21] Derinlik elektrodları yerleştirilen meziyal temporal epilepsi olgularında hipokampusta ve diğer meziyal temporal yapılarda ortaya çıkan uzun epileptik deşarjlar sırasında skalp EEG'de uyanıklıktaki EEG özelliklerini incelemişlerdir. [30] Bu hastalarda en az bir hemisferde normal fizyolojik zemin aktivitesinin korunduğu unilateral ya da fokal anormallikler orta şiddette unilateral hareket bozuklukları iyi prognozla ilişkili bulunurken, fizyolojik zemin aktivitesinin olmadığı yaygın anormallikler ağır nörolojik bozukluk ve kötü prognozla ilişkili bulunmuştur. [30] EEG'de uyanıklıkta ağır nörolojik ve kognitif bozukluğa eşlik eden yüksek amplitüdlü yavaş dalgaların izlenmesi NMDAR'ın glutamerjik intrakortikal bağ-lantılarla desteklediği aktif kortikal durumu sağlamasındaki rolüyle ilişkilendirilmiştir.…”

Section: Voltaj Bağımlı Potasyum Kanal Kompleks (Vgkc) Antikorlarına unclassified

“…[30] Bu hastalarda en az bir hemisferde normal fizyolojik zemin aktivitesinin korunduğu unilateral ya da fokal anormallikler orta şiddette unilateral hareket bozuklukları iyi prognozla ilişkili bulunurken, fizyolojik zemin aktivitesinin olmadığı yaygın anormallikler ağır nörolojik bozukluk ve kötü prognozla ilişkili bulunmuştur. [30] EEG'de uyanıklıkta ağır nörolojik ve kognitif bozukluğa eşlik eden yüksek amplitüdlü yavaş dalgaların izlenmesi NMDAR'ın glutamerjik intrakortikal bağ-lantılarla desteklediği aktif kortikal durumu sağlamasındaki rolüyle ilişkilendirilmiştir. Bu hastalarda NREM uykusunda fizyolojik yavaş dalga bileşenlerinin azaldığı, fokal ya da yaygın teta-alfa bandında ritmlerinin ortaya çıktığı izlenmiş bu durum ise NMDAR'ın uykuda kortikal yavaş dalga osilasyonunun ortaya çıkması ve talamik yavaş dalgaların kortikal yavaş osilasyonu indüklemesi ve senkronizasyonu ile ilgili rolüyle ilişkili bulunmuştur.…”

Section: Voltaj Bağımlı Potasyum Kanal Kompleks (Vgkc) Antikorlarına unclassified

Common EEG Patterns in Autoimmune Encephalitis and Paraneoplastic Neurological Syndromes

Baysal-Kıraç¹

2015

Epilepsi

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SummaryAutoimmune encephalitis is a group of syndromes with subacute onset of amnesia, confusion and prominent seizures which may have paraneoplastic or immune-mediated etiology. Nearly half of the patients diagnosed with autoimmune limbic encephalitis have experienced seizures, prominently refractory nonconvulsive seizures and nonconvulsive status epilepticus. EEG is an important diagnostic tool in diagnosis and follow-up of the patients with autoimmune encephalitis. Here, we aim to review the EEG findings which were detected in the different autoimmun encephalitis and paraneoplastic neurological syndromes.

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Early electro-clinical features may contribute to diagnosis of the anti-NMDA receptor encephalitis in children

Cited by 71 publications

References 28 publications

Autoimmune Encephalitis: Pathophysiology and Imaging Review of an Overlooked Diagnosis

Autoimmune Encephalitis: Pathophysiology and Imaging Review of an Overlooked Diagnosis

Extreme Delta Brushes in Pediatric Anti-N-Methyl-DAspartate Receptor Encephalitis

Common EEG Patterns in Autoimmune Encephalitis and Paraneoplastic Neurological Syndromes

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