Utility of Neurodiagnostic Studies in the Diagnosis of Autoimmune Encephalitis in Children

Albert, Dara V.F.; Pluto, Charles P.; Weber, Amanda; Vidaurre, Jorge; Barbar-Smiley, Fatima; Abdul-Aziz, Rabheh; Driest, Kyla; Bout-Tabaku, Sharon; Ruess, Lynne; Rusin, Jerome; Morgan-Followell, Bethanie

doi:10.1016/j.pediatrneurol.2015.10.016

Cited by 22 publications

(22 citation statements)

References 19 publications

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“…The EEG abnormalities found in our patient were highly characteristic. Different interictal EEG patterns have been described in anti-NMDA receptor encephalitis including a non-specific and polymorphic generalized or focal slowing, mainly frontotemporal, polymorphic slowing, excessive beta frequency activity, and their co-occurrence, known as “extreme delta brush”, which is considered highly specific of the disease [5], [11], [12], [13], [14], [15], [16], [17], [18], [19], [20], [21]. On the other hand, focal seizures with a characteristic ictal electroclinical pattern have been reported in children with anti-NMDA receptor encephalitis.…”

Section: Discussionmentioning

confidence: 99%

Unilateral predominance of abnormal movements: A characteristic feature of the pediatric anti-NMDA receptor encephalitis?

Benjumea-Cuartas¹,

Eisermann²,

Simonnet³

et al. 2017

Epilepsy & Behavior Case Reports

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Anti-NMDA receptor encephalitis is a treatable autoimmune disease characterized by cognitive, motor and psychiatric features that primarily affects young adults and children. We present a case of a 7-year-old boy with asymmetrical (mainly right hemibody) and abnormal polymorphic movements without concomitant scalpictal EEG changes but had background slowing predominating over the left hemisphere. This report illustrates previous descriptions of asymmetric presentation of abnormal movements in pediatric anti-NMDA receptor encephalitis and emphasizes the importance of video-EEG interpreted within the overall clinical context, to differentiate epileptic from non-epileptic abnormal movements in patients with autoimmune encephalitis.

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Section: Discussionmentioning

confidence: 99%

Unilateral predominance of abnormal movements: A characteristic feature of the pediatric anti-NMDA receptor encephalitis?

Benjumea-Cuartas¹,

Eisermann²,

Simonnet³

et al. 2017

Epilepsy & Behavior Case Reports

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“…In the diagnosis, treatment, and evaluation of anti-NMDAR encephalitis, EEG plays an important role due to its convenience, speed, and noninvasiveness. Seizures and movement disorders in anti-NMDAR encephalitis are easily confused [40], and EEG has been posited as a necessary auxiliary test for the differential diagnosis [41]. Studies have shown that in the most severe cases of anti-NMDAR encephalitis, EEG abnormalities are more helpful for diagnosing the disease than magnetic resonance imaging (MRI) (98.4% vs. 46.8%) [42].…”

Section: Auxiliary Inspectionmentioning

confidence: 99%

“…Studies have shown that in the most severe cases of anti-NMDAR encephalitis, EEG abnormalities are more helpful for diagnosing the disease than magnetic resonance imaging (MRI) (98.4% vs. 46.8%) [42]. In addition to seizures, common EEG abnormalities in anti-NMDAR encephalitis include nonspecific diffuse slow waves [43] and specific delta brushes (extreme delta brush (EDB)), among others [41]. Since EDB is more common in comatose patients and other severe cases, it is currently considered to indicate a poor prognosis [21,44,45].…”

Section: Auxiliary Inspectionmentioning

confidence: 99%

Current Progress on Assessing the Prognosis for Anti-N-Methyl-D-Aspartate Receptor (NMDAR) Encephalitis

Wang

Xiao

2020

BioMed Research International

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Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is the most common antineuronal antibody encephalitis in autoimmune encephalitis found at present. It has complex clinical manifestations such as psychiatric and behavioral abnormalities, seizures, movement disorders, consciousness, and autonomic dysfunction. The relationship between those manifestations and prognosis is unclear. Electroencephalography (EEG) is gradually becoming useful in the evaluation of the prognosis of anti-NMDAR encephalitis patients, while imaging and antibody testing have a limited prognostic value. Starting the patients on adequate treatments (such as immunotherapy) in a timely fashion has a positive impact on their prognosis. Nevertheless, research on the prognosis of anti-NMDAR encephalitis remains scarce. Here, we review the current advances of prognosis-related research from the clinical manifestations of the disease and auxiliary examinations such as EEG, magnetic resonance imaging (MRI), 18F fluorodeoxyglucose positron emission tomography (FDG-PET), and antibody measurement. In addition, we also discuss the impact of different treatment options on prognosis. In-depth research on the prognosis of patients with anti-NMDAR encephalitis will contribute to a better understanding of this disease, leading to better treatments options and, ultimately, a better prognosis.

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“…7 Al momento de realizarse un electroencefalograma en pacientes con encefalitis autoinmune se observa actividad delta en regiones temporales, o actividad delta rítmica generalizada con actividad rápida superpuesta (delta brush), encontrándose un electroencefalograma anormal hasta en 90% de los casos. 5,9 La tomografía computada con emisión de positrones puede mostrar cambios hipo o hipermetabólicos en diversas áreas del cerebro de pacientes con cuadro clínico sugestivo, pero sin hallazgos en resonancia magnética. 1,9 En el caso de la encefalitis por anticuerpos anti-NMDA el cuadro se caracteriza por manifestaciones neuropsiquiátricas, epilepsia refractaria, estado epiléptico y movimientos anormales (e.g.…”

Section: Abordaje Diagnósticounclassified

Encefalitis autoinmune en pediatría

et al. 2017

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274www.actapediatrica.org.mx criterio pediátrico DEFINICIÓNLa encefalitis es un desorden inflamatorio del encéfalo que deriva en un estado mental alterado, crisis convulsivas, déficits neurológicos focales, acompañado usualmente de signos de inflamación en el líquido cefalorraquídeo y hallazgos en la resonancia magnética que pueden ir desde normalidad hasta anormalidades extensas.1 La encefalitis puede ocurrir como resultado de una infección primaria del sistema nervioso central, o bien, por un proceso autoinmune desencadenado por una infección, vacuna o neoplasia oculta.2 La encefalitis autoinmune involucra varios tipos de entidades con diferentes fisiopatologías, el entender estas entidades nos ayuda a utilizar los recursos y elementos diagnósticos necesarios, así como la mejor estrategia terapéutica. 3 EPIDEMIOLOGÍAEn Estados Unidos se ha estimado que ocurren aproximadamente 20,000 casos de encefalitis por año, y que aproximadamente en 50% de los casos reportados no se identificaron agentes infecciosos como agentes causales, determinándose en la mayoría una asociación autoinmune. 4 En México no contamos con datos disponibles respecto a este padecimiento de forma específica. Algunos estudios han sugerido que existe un predomino de presentación en el sexo femenino con un aproximado de 67% y una edad promedio de 10.1 años. 5 COMORBILIDADESLa comorbilidad mayormente descrita han sido teratomas ováricos en más de 1/3 de mujeres adultas con diagnóstico de

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Utility of Neurodiagnostic Studies in the Diagnosis of Autoimmune Encephalitis in Children

Cited by 22 publications

References 19 publications

Unilateral predominance of abnormal movements: A characteristic feature of the pediatric anti-NMDA receptor encephalitis?

Unilateral predominance of abnormal movements: A characteristic feature of the pediatric anti-NMDA receptor encephalitis?

Current Progress on Assessing the Prognosis for Anti-N-Methyl-D-Aspartate Receptor (NMDAR) Encephalitis

Encefalitis autoinmune en pediatría

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