Expanding Spectrum of Encephalitis With NMDA Receptor Antibodies in Young Children

Lebas, Axel; Husson, B.; Didelot, Adrien; Honnorat, Jérôme; Tardieu, Marc

doi:10.1177/0883073809343319

Cited by 70 publications

(37 citation statements)

References 15 publications

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“…Other known tumour associations include mediastinal teratomas and sex-cord stromal tumours [1] and there have been reported links with neuroblastomas [9] and Hodgkin's lymphoma [10]. We also found a report of a possible link with the TdaP-IPV vaccine (for tetanus, diphtheria, pertussis and polio), with the patient having a prodromal illness 24 hours post vaccine and classical psychiatric symptoms 5 weeks later [11].…”

Section: Epidemiologysupporting

confidence: 57%

Anti-NMDA Receptor Encephalitis

Ferdinand¹

2013

J Clin Cell Immunol

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In recent years, the discovery of antibodies to specific neuronal antigens that then go on to cause encephalitis has gone a long way to change the investigation and management of a potential encephalitic process. These have now become known under the umbrella term of the 'autoimmune encephalitides'. In this article we look at anti-N-methyl-D-aspartate receptor encephalitis, a condition most often found in young females and has an association with a number of malignancies, most commonly ovarian teratomas. Most patients will have a viral prodrome, followed by psychiatric, seizure, dysautonomic and dyskinetic features, but can present at any point along this pathway. Treatment involves prompt tumour identification and removal where appropriate and initiation of immunosuppressive therapy, usually commencing with corticosteroids. A substantial proportion of patients will make a full recovery, but many will need medical, psychiatric and social care following completion of the acute phase of the illness.

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Section: Epidemiologysupporting

confidence: 57%

Anti-NMDA Receptor Encephalitis

Ferdinand¹

2013

J Clin Cell Immunol

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“…Serum NMDAR antibody titers were shown to fall in patients who showed clinical improvement. Other tumors have been noted in individual patients, including a teratoma of the mediastinum [1•], teratoma of the testicle [7], sex cord-stromal tumor [6••], Hodgkin's lymphoma [8], small cell lung carcinoma [9], and neuroblastoma [10].…”

Section: Paraneoplastic Originsmentioning

confidence: 99%

NMDA Receptor Antibody Encephalitis

Irani

Vincent

2011

Curr Neurol Neurosci Rep

100

105

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N-methyl-D-aspartate receptor (NMDAR) antibody encephalitis is a recently described immunotherapy-responsive panencephalitis with characteristic features that include a psychiatric onset and a later movement disorder. This entity was first described as a paraneoplastic phenomenon in young women with ovarian teratomata. However, more recently it has become clear that the majority of patients, particularly children, do not harbor a tumor and that males can also be affected. With the development of the NMDAR antibody assay, now available worldwide, a few patients with classical limbic encephalitis and early psychosis and epilepsy have also been found to harbor these antibodies. Early diagnosis followed by immunotherapies and tumor removal, when relevant, expedite recovery from the condition. Antibody levels correlate with the clinical severity of the disease in individual patients, and the antibodies have been shown to substantially reduce NMDA receptors on hippocampal neurons both in vitro and in vivo, supporting the likely direct pathogenicity of the NMDAR antibodies.

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“…It has led to the identification of an increasing cluster of autoimmune encephalitis related to antibodies against synaptic proteins (8,10). Rapidly progressive alterations of consciousness, memory, orientation, behavior and development of psychotic symptoms (hallucinations or delusions) previously thought to be idiopathic or because of viral infection are now documented to be autoimmune in nature (11,12,13).…”

Section: Discussionmentioning

confidence: 99%

Anti-N-Methyl-D-Aspartate-Receptor Encephalitis, a Challenge for Neurologists or a Chameleon for Psychiatrists: A Case Report

Ali

Amir

Rezaeitalab

et al. 2015

Caspian.J.Neurol.Sci

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Anti-N-Methyl-D-Aspartate-Receptor (NMDA-R) encephalitis is a new autoimmune disorder, often paraneoplastic in nature, presenting with complex neuropsychiatric symptoms. Diagnosed serologically, this disorder is often responsive to immunosuppressant treatment. We here in report the case of a 56-year-old man with anti NMDA-R encephalitis presenting initially with disorientation and hallucination. He later developed bilateral ophthalmoplegia and spastic tetraparesis. Neurological examination showed mild consciousness disturbance and bilateral ophthalmoplegia on admission, spastic tetraparesis with limbs hyperreflexia. Cerebrospinal fluid samples showed mild pleocytosis. MRI disclosed some small hypersignal lesions in the FLAIR. Anti-NMDA-R antibody was diagnosed upon detection of antibody in the serum. Psychiatrists and neurologists should pay more attention to the cranial, mental and behavioral involvement due to this potentially fatal disease.

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Expanding Spectrum of Encephalitis With NMDA Receptor Antibodies in Young Children

Cited by 70 publications

References 15 publications

Anti-NMDA Receptor Encephalitis

Anti-NMDA Receptor Encephalitis

NMDA Receptor Antibody Encephalitis

Anti-N-Methyl-D-Aspartate-Receptor Encephalitis, a Challenge for Neurologists or a Chameleon for Psychiatrists: A Case Report

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