Clinical diagnosis and treatment of pediatric anti‑N‑methyl‑D‑aspartate receptor encephalitis: A single center retrospective study

  • Authors:
    • Yang Sai
    • Xiao Zhang
    • Mei Feng
    • Jingwen Tang
    • Hongmei Liao
    • Lihong Tan
  • View Affiliations

  • Published online on: June 20, 2018     https://doi.org/10.3892/etm.2018.6329
  • Pages: 1442-1448
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Abstract

The aim of the present retrospective study was to investigate the diagnosis, treatment and prognosis of pediatric anti‑N‑methyl‑D‑aspartate receptor (anti‑NMDAR) encephalitis. A total of 23 pediatric patients with anti‑NMDAR encephalitis were included in the present study. The clinical data, laboratory test results, imaging examination, treatment outcomes, and follow‑up records were reviewed and analyzed. A total of 8 patients exhibited prodromal symptoms, including fever, cough, and vomiting. Clinical symptoms included epilepsy, convulsions, ataxia, coma, dyskinesia, personal behavior change and hallucinations. A total of 20 cases had the initial neurologic symptoms of dyskinesia or seizure, whereas 3 cases exhibited psychiatric symptoms of personal behavior change and hallucinations. Furthermore, pediatric patients >6 years old had more psychiatric symptoms than those ≤6 years. A total of 20 cases exhibited abnormal electroencephalography records, with 1 case of extreme δ brush. A total of 10 cases exhibited abnormal brain magnetic resonance imaging detection. Furthermore, the CSF protein contents for pediatric patients ≤6 years old was significantly higher than those >6 years. For treatment, 18 pediatric patients received the first‑line treatment of methylprednisone and intravenous injection of immunoglobulin, and 6 cases were subjected to the second‑line treatment of rituximab. A total of 2 patients underwent plasma exchange and/or cyclophosphamide treatment. In follow‑up, 12 cases reported no convulsion, whereas 11 cases had moderate or severe neurological and psychiatric sequelae. The recovery rate for pediatric patients ≤6 years old was significantly higher than those >6 years. Anti‑NMDAR encephalitis is commonly seen in pediatric patients, mainly with initial neurological symptoms. These patients could respond to immunotherapy, and younger pediatric patients typically have a better prognosis.
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August-2018
Volume 16 Issue 2

Print ISSN: 1792-0981
Online ISSN:1792-1015

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Spandidos Publications style
Sai Y, Zhang X, Feng M, Tang J, Liao H and Tan L: Clinical diagnosis and treatment of pediatric anti‑N‑methyl‑D‑aspartate receptor encephalitis: A single center retrospective study. Exp Ther Med 16: 1442-1448, 2018.
APA
Sai, Y., Zhang, X., Feng, M., Tang, J., Liao, H., & Tan, L. (2018). Clinical diagnosis and treatment of pediatric anti‑N‑methyl‑D‑aspartate receptor encephalitis: A single center retrospective study. Experimental and Therapeutic Medicine, 16, 1442-1448. https://doi.org/10.3892/etm.2018.6329
MLA
Sai, Y., Zhang, X., Feng, M., Tang, J., Liao, H., Tan, L."Clinical diagnosis and treatment of pediatric anti‑N‑methyl‑D‑aspartate receptor encephalitis: A single center retrospective study". Experimental and Therapeutic Medicine 16.2 (2018): 1442-1448.
Chicago
Sai, Y., Zhang, X., Feng, M., Tang, J., Liao, H., Tan, L."Clinical diagnosis and treatment of pediatric anti‑N‑methyl‑D‑aspartate receptor encephalitis: A single center retrospective study". Experimental and Therapeutic Medicine 16, no. 2 (2018): 1442-1448. https://doi.org/10.3892/etm.2018.6329