Paraneoplastic anti-NMDAR encephalitis: long term follow-up reveals persistent serum antibodies

Alexopoulos, Harry; Kosmidis, Michalis L.; Dalmau, Josep; Dalakas, Marinos C.

doi:10.1007/s00415-011-5982-4

Cited by 35 publications

(30 citation statements)

References 5 publications

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“…Sometimes, the autoimmune disorder, including the seizures, can be effectively controlled with clinical immunotherapy treatment despite the fact that the antibodies are persistently detectable in sera (Alexopoulos et al 2011;Lancaster et al 2011). Such reports of seizures arising from autoimmune attack of glutamate receptors further implicate the glutamatergic system in epilepsy.…”

Section: Epilepsy-related Phenotypes Associated With Aberrant Glutamamentioning

confidence: 99%

Glutamatergic Mechanisms Associated with Seizures and Epilepsy

Barker‐Haliski

White

2015

Cold Spring Harb Perspect Med

299

211

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Epilepsy is broadly characterized by aberrant neuronal excitability. Glutamate is the predominant excitatory neurotransmitter in the adult mammalian brain; thus, much of past epilepsy research has attempted to understand the role of glutamate in seizures and epilepsy. Seizures induce elevations in extracellular glutamate, which then contribute to excitotoxic damage. Chronic seizures can alter neuronal and glial expression of glutamate receptors and uptake transporters, further contributing to epileptogenesis. Evidence points to a shared glutamate pathology for epilepsy and other central nervous system (CNS) disorders, including depression, which is often a comorbidity of epilepsy. Therapies that target glutamatergic neurotransmission are available, but many have met with difficulty because of untoward adverse effects. Better understanding of this system has generated novel therapeutic targets that directly and indirectly modulate glutamatergic signaling. Thus, future efforts to manage the epileptic patient with glutamatergic-centric treatments now hold greater potential.

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Section: Epilepsy-related Phenotypes Associated With Aberrant Glutamamentioning

confidence: 99%

Glutamatergic Mechanisms Associated with Seizures and Epilepsy

Barker‐Haliski

White

2015

Cold Spring Harb Perspect Med

299

211

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“…It is very likely that rituximab was the most beneficial immunotherapy because improvement of PERM's symptomatology was temporally connected to the initiation of rituximab therapy and was associated with reduction of GlyR titers. The persistence of low titers antibodies in the serum even after disease resolution is not, however, unexpected as often antineuronal antibodies may persist in the serum [Alexopoulos et al 2011]. Whether this constitutes a sign for a possible relapse is unclear.…”

Section: Discussionmentioning

confidence: 99%

Progressive encephalomyelitis with rigidity and myoclonus (PERM): brucellosis as a possible triggering factor and long-term follow-up therapy with rituximab

Magira

Alexopoulos

Charitatos

et al. 2015

Ther Adv Neurol Disord

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“…On contrary death had been reported due to delay in diagnosis of tumour (3,11,12). A few reports also showed that clinical improvement with blind ovariectomy despite negative imaging which later revealed an occult teratoma (13,14,15). In this patient a right salpingooophorectomy was performed as the tumour was big.…”

Section: Discussionmentioning

confidence: 99%

Anti N-Methyl-D-Aspartate Receptor Encephalitis with Ovarian Teratoma: A Dilemma in Diagnosis

Ismail¹

2016

JSA

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We report a rare case of altered mental status in a young patient with immature ovarian teratoma. A 22-year-old woman presented with seizures, hallucination, amnesia and orofacial dyskinesia. Examination and investigation revealed an ovarian massand asalphing-oophorectomy was performed. The histopathological examination result showed an immature teratoma grade 2 with thepresence of immature primitive glial tissue. Her CSF N-Methyl-DAspartic acid receptor (Anti-NMDAR) antibodytest was positive. N-Methyl-D-Aspartic acid receptor antibody associated limbic encephalitis is an autoimmune antibody-mediated neuropsychiatric disorder. Resection of the tumour and immunotherapy resulted in full recovery.

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Paraneoplastic anti-NMDAR encephalitis: long term follow-up reveals persistent serum antibodies

Cited by 35 publications

References 5 publications

Glutamatergic Mechanisms Associated with Seizures and Epilepsy

Glutamatergic Mechanisms Associated with Seizures and Epilepsy

Progressive encephalomyelitis with rigidity and myoclonus (PERM): brucellosis as a possible triggering factor and long-term follow-up therapy with rituximab

Anti N-Methyl-D-Aspartate Receptor Encephalitis with Ovarian Teratoma: A Dilemma in Diagnosis

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