AntiNMDA

Background: The immunotherapy that is more effective for seizures caused by viral encephalitis and autoimmune encephalitis and the long-term use of anti-epileptic drugs is not clear. We aimed to compare the immunotherapy and prognosis of seizures caused by viral encephalitis a...

Here, Harald Prüss discusses how autoantibodies can contribute to neurological diseases. The identification of specific autoantibodies to neuronal and glial targets has increased our understanding of autoimmunity in the central nervous system and led to the reclassification of some diseases...

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Objective To report the identification of antibodies against the glutamate kainate receptor subunit 2 (GluK2‐abs) in patients with autoimmune encephalitis, and describe the clinical‐immunological f...

The incidence of PSH in severe anti-NMDARE patients was as high as 50%. Patients with PSH demonstrated prolonged NICU stay, hospital stay and increased duration of mechanical ventilation, while no effect on hospital mortality and functional outcome.

Advances in autoimmune encephalitis studies in the past 10 years have led to the identification of new syndromes and biomarkers that have transformed the diagnostic approach to the disorder. The disorder or syndrome has been linked to a wide variety of ...

Therapeutic plasma exchange (TPE) has been a key immunotherapeutic strategy in numerous neurological syndromes, predominantly during the acute phase of illness. This paper reviews the indications, ...

Background To explore the characteristics and prognosis of autonomic dysfunction and paroxysmal sympathetic hyperactivity (PSH), and evaluate the efficacy of drugs used to suppress PSH episode in anti-NMDAR encephalitis patients.MethodsPat...

Anti-NMDAR encephalitis in infants and toddlers clinically presents with movement disorders, developmental regression, and abnormal behaviors. Interestingly, this group had a higher proportion of patients after viral encephalitis, which is regarded as the only risk factor for poor outcomes.

Autoimmune encephalitis (AE) is an increasingly recognized inflammatory disorder of the central nervous system and is most often characterized by anti…...

This article on paraneoplastic neurologic disorders provides an update on the diagnostic approach, utility and pitfalls of autoantibody testing and emerging settings in which these disorders are encountered.

Science saved my daughter's life. Then another fear took hold.

Anti-NMDA receptor (NMDAR) encephalitis was first reported to develop in female young adults with ovarian teratoma. However, another study with a larger cohort reported that more than one-third of all patients with anti-NMDAR encephalitis were aged under 18 years, suggesting that this encephalitis...

Create a free QxMD account to take advantage of the features offered by Read like saving your papers and creating collections. Get Started JOURNAL ARTICLEREVIEW Pediatric Autoimmune Encephalitis and Its Relationship With Infection Qinrui Li, Na Fu, Ying Han, Jiong Qin Pediatric Neurology 2021 April 7, 120: 27-32 Autoimmune encephalitis (AE) is an increasingly recognized inflammatory disorder of the central nervous system and is most often characterized by antibodies against intracellular and neuronal surface antigens. AE is a devastating disease that may result in developmental delay or regression in children. However, the pathogenesis of AE is not clear, and immune system disorders after infection likely play an important role in AE. Many studies have reported that patients with herpes simplex virus encephalitis develop anti-N-methyl-d-aspartate receptor encephalitis after antiviral treatment. It is critical to recognize pediatric AE early and to distinguish it from infectious forms because AE is treatable and responsive to immunotherapies. In this review, we discuss the clinical features of pediatric AE and focus on the relationship between AE and postinfection status. In addition, we review the probable mechanisms underlying infection-triggered AE, which include molecular mimicry, bystander activation, epitope spreading, immune system disorder, and genetic susceptibility. Full Text Links We have located links that may give you full text access. Full Text Web Additional links Discussion You are not logged in. Sign Up or Log In to join the discussion. Trending Papers US Case Reports of Cerebral Venous Sinus Thrombosis With Thrombocytopenia After Ad26.COV2.S Vaccination, March 2 to April 21, 2021. Isaac See, John R Su, Allison Lale, Emily Jane Woo, Alice Y Guh, Tom T Shimabukuro, Michael B Streiff, Agam K Rao, Allison P Wheeler, Suzanne F Beavers, Anna P Durbin, Kathryn Edwards, Elaine Miller, Theresa A Harrington, Adamma Mba-Jonas, Narayan Nair, Duong T Nguyen, Kawsar R Talaat, Victor C Urrutia, Shannon C Walker, C Buddy Creech, Thomas A Clark, Frank DeStefano, Karen R Broder JAMA 2021 April 30 Preliminary Findings of mRNA Covid-19 Vaccine Safety in Pregnant Persons. Tom T Shimabukuro, Shin Y Kim, Tanya R Myers, Pedro L Moro, Titilope Oduyebo, Lakshmi Panagiotakopoulos, Paige L Marquez, Christine K Olson, Ruiling Liu, Karen T Chang, Sascha R Ellington, Veronica K Burkel, Ashley N Smoots, Caitlin J Green, Charles Licata, Bicheng C Zhang, Meghna Alimchandani, Adamma Mba-Jonas, Stacey W Martin, Julianne M Gee, Dana M Meaney-Delman New England Journal of Medicine 2021 April 21 Advances in Clinical Cardiology 2020: A Summary of Key Clinical Trials. Aileen Kearney, Katie Linden, Patrick Savage, Ian B A Menown Advances in Therapy 2021 April 12 Palpitations in the Clinic. Jacob L Ransom, Ka C Wong Circulation 2021 April 20, 143 (16): 1631-1634 Neurologic Assessment of the Neurocritical Care Patient. Shane Musick, Anthony Alberico Frontiers in Neurology 2021, 12: 588989 The Role of Procalcitonin in Antibiotic Decision-Making in Covid-19 Infection. Valeria Fabre, Sara Karaba, Joe Amoah, Matthew Robinson, George Jones, Kathryn Dzintars, Morgan Katz, B Mark Landrum, Sarojini Qasba, Pooja Gupta, Eili Klein, Sara E Cosgrove Infection Control and Hospital Epidemiology 2021 April 19, : 1-24 Coronary Microvascular Dysfunction. Shigeo Godo, Akira Suda, Jun Takahashi, Satoshi Yasuda, Hiroaki Shimokawa Arteriosclerosis, Thrombosis, and Vascular Biology 2021 March 25, : ATVBAHA121316025 Perioperative hypotension 2021: a contrarian view. Teus Kappen, William Scott Beattie British Journal of Anaesthesia 2021 April 23

ICPI-AIE consists of a heterogenous group of conditions. Neurologists will likely encounter ICPI-AIE more often in the future, but important unresolved questions include the exact pathophysiological mechanisms, the epidemiology and the best treatment approaches associated with ICPI-AIE.

The co-existence of anti-N-methyl-D-aspartate receptor encephalitis (NMDARe) and anti-myelin oligodendrocyte glycoprotein (MOG) antibody disease has s…...

In this study, while presenting a clinical case with early psychiatric manifestations, we emphasized the need to pay attention to neurological diagnoses such as Anti N‐Methyl‐D‐Aspartate Receptor (NMDAR) encephalitis at the time ...

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The causes of encephalitis are numerous, and extensive investigations for infectious agents and other etiologies are often negative. The discovery that many of these encephalitis are immune mediated has changed the approach to the diagnosis and treatment of these disorders.

Considering the similarities with other pandemics due to respiratory virus infections and subsequent development of neurological disorders (e.g. encephalitis lethargica after the 1918 influenza), there is growing concern about a possible new wave of neurological complications following the...

Anti-N-methyl-D-aspartate (anti-NMDA) receptor encephalitis is an immune-mediated syndrome that is still under-recognised, with grave consequences if not treated early.A multidisciplinary team approach is required in the process of diagnosis and management of this potentially treatable and reversib...

Abstract Objective To evaluate the validity of the 2016 clinical diagnostic criteria proposed for probable anti-NMDA receptor (NMDAR) encephalitis in children, we tested the criteria in a Japanese pediatric cohort. Methods We retrospectively reviewed clinical information of patients with neurologic symptoms whose CSF was analyzed for NMDAR antibodies (NMDAR-Abs) in our laboratory from January 1, 2015, to March 31, 2019. Results Overall, 137 cases were included. Of the 41 cases diagnosed as probable anti-NMDAR encephalitis (criteria-positive) according to the 2016 criteria, 13 were positive and 28 were negative for anti–NMDAR-Abs. Of the 96 criteria-negative cases, 3 were positive and 93 were negative for anti–NMDAR-Abs. The sensitivity of the criteria was 81.2%, specificity was 76.9%, positive predictive value (PPV) was 31.7%, and negative predictive value was 96.9%. Compared with the true-positive group, the false-positive group contained more male than female patients (male:female, 4:9 in the true-positive vs 19:9 in the false-positive group, p = 0.0425). The majority of the cases with false-positive diagnoses were associated with neurologic autoimmunity. Conclusion The clinical diagnostic criteria are reliable for deciding to start immunomodulatory therapy in the criteria-positive cases. Low PPV may be caused by a lower prevalence of NMDAR encephalitis or lower level of suspicion for encephalitis in the pediatric population. Physicians should therefore continue differential diagnosis, focusing especially on other forms of encephalitis. Classification of Evidence This study provides Class IV evidence that the proposed diagnostic criteria for anti-NMDAR encephalitis in children has a sensitivity of 81.2% and a specificity of 76.9%. Glossary AMPAR=α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor; CASPR2=contactin-associated protein-like 2; CI=confidence interval; GABABR=γ-aminobutyric acid B receptor; GFP=green fluorescence protein; HSV=herpes simplex virus; IgG=immunoglobulin G; LGI1=leucine-rich glioma-inactivated 1; MOG=myelin oligodendrocyte glycoprotein; NMDAR=NMDA receptor; NMDAR-Abs=NMDA receptor antibodies; PPV=positive predictive value Footnotes Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article. Class of Evidence: NPub.org/coe CME Course: NPub.org/cmelist Received June 12, 2020. Accepted in final form January 25, 2021. © 2021 American Academy of Neurology