AntiNMDA

AS ONE of our most respected TV writers, Abi Morgan is no stranger to a bizarre plot twist.

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Question: Who treats autoimmune encephalitis (AE)? The traditional answer: neurologists. The jaded answer: no one does. The real answer: a haphazard smattering of medical professionals who balance their knowledge of medical literature with sound clinical judgement and the needs of the patient.

Seronegative autoimmune encephalitis (AE) is AE without any identifiable pathogenic antibody. Although it is a major subtype of AE, many unmet clinical needs exist in terms of clinical characteristics, treatments, and prognosis.

Encephalitis is a severe inflammatory disorder of the brain with many possible causes
and a complex differential diagnosis. Advances in autoimmune encephalitis research in the past 10 years have led to the identification of new syndromes and biomarkers that have transformed the diagnostic approach...

The hippocampus can be affected by a wide range of diseases that may have similar clinical findings, but an imaging algorithm that organizes the diseases into nodular (space occupying) versus nonno...

PurposeTo investigate the clinical characteristics of acute symptomatic seizures and the predictors of the development of epilepsy in patients with anti-NMDAR, anti-LGI1, and anti-GABABR encephalitis.MethodsWe retrospectively screened the medical records of 86 hospitalized patients with confirmed...

ObjectiveThe aim of this study was to analyze the positive rate and test strategies of suspected autoimmune encephalitis (SAE) based on an antibody assay.MethodsPatients who were diagnosed with suspected autoimmune encephalitis in Guizhou Province between June 1, 2020, and June 30, 2021 and who...

ObjectiveTo establish the diagnostic biomarker of electroencephalogram (EEG) to distinguish between anti-N-methyl-d-aspartate receptor encephalitis (NMDARE) and other types of autoimmune encephalitis (other AEs).MethodsWe reviewed the clinical records of 90 patients with acute encephalitis who...

Triphasic waves (TWs) are mainly described in association with metabolic encephalopathy, especially hepatic encephalopathy. Now, as different conditions including non-metabolic and structural abnormalities have been reported to be associated with TWs, ...

Barrow Saves Woman With Rare Neuroimmune Disorder Your Impact Your Impact: Overview Patient Stories Donor Stories Impact Report Barrow Saves Woman With Rare Neuroimmune Disorder In April 2020, 27-year-old Reyna Felix was working a typical night shift at her job as a 911 fire dispatcher. But her co-workers noticed that she wasn’t acting like herself. She was also sending strange text messages to her family and friends, telling them she was depressed and unhappy with her life, work, and education. Then around midnight, she collapsed and had a seizure. Reyna doesn’t remember any of it. In fact, most of her memory from the seven months prior to the seizure, as well as the two months after it, is gone. Those closest to Reyna say she had been exhibiting mood swings and erratic behavior as early as September 2019. Her husband recalls one particular incident while they were on vacation in California and she told him she had a hallucination about driving her car off of a cliff. Between that first hallucination and the seizure, Reyna went through several periods during which her family and friends noticed a considerable difference in her personality. However, she always seemed to bounce back to her normal self, so they contributed it to stress. That wasn’t the case. On that fateful April night when Reyna had the seizure she was taken immediately to the emergency room. After multiple tests and an MRI came out inconclusive, they sent her home. The next three weeks were a series of nightmares for Reyna’s husband and family. In addition to multiple seizures, Reyna continued to have hallucinations, didn’t recognize her loved ones, and didn’t have a sense of time or place. She even repeatedly tried to escape her own home, forcing her husband to buy child-proof locks to keep her from leaving. Doctors had no idea what was causing the normally happy, outgoing woman to have these distressing episodes. In the midst of being evaluated for schizophrenia, Reyna’s doctors became concerned for her safety, so they transferred her to a psychiatric facility. That’s when things took a turn for the worse. While receiving treatment at the psychiatric facility, Reyna started having heart problems and went into cardiac arrest. After being revived, she was transported back to the hospital, where she started having significant trouble breathing. “The doctor at that hospital came up with several possibilities, including meningitis and encephalitis. Unfortunately, they didn’t have the specialists available on staff to treat me, so I was sent home,” says Reyna. The next day, she went into cardiac arrest again. Reyna was revived and transported to the hospital for the second time in a week. However, doctors were still hesitant to treat her or give her a formal diagnosis. Finally, her family asked to consult Barrow Neurological Institute. At Barrow, Ram Narayan, MD, was able to give Reyna’s family what doctors at the other seven hospitals she was admitted to couldn’t: a diagnosis. Reyna was diagnosed with Anti-NMDA Receptor Encephalitis, a rare condition that causes inflammation of the brain and is often misdiagnosed as a mental illness. Luckily, Dr. Narayan holds a certification in rare neuroimmune disorders (CRND) and is trained to treat conditions such as Anti-NMDA Receptor Encephalitis. He began an intensive treatment plan for Reyna right away. “Dr. Narayan saved my life. He’s one of the few doctors who specializes in encephalitis, so I trust him over all the other doctors we’ve interacted with,” she says. While Dr. Narayan was able to treat Reyna, the encephalitis caused significant trauma to her brain. “I had to learn how to do everything again—walk, talk, write, and even eat,” she says. Reyna stayed in the Barrow Neuro-Rehabilitation Center, where she received physical therapy, speech therapy, and occupational therapy, along with continued treatment from Dr. Narayan. She recalls one of her greatest triumphs when she improved enough to go outside. “My occupational therapist took me out for a walk and helped me along as I used my cane. I’ll never forget being outside with the sun shining on me for the first time in what felt like forever.” Still, recovery from a condition like encephalitis is unpredictable, so Reyna wasn’t sure if she would be able go back to a fast-paced, high-stress job like she had as a 911 dispatcher. “With my hard work, and with the help of Dr. Narayan, my neuro-rehabilitation doctor, the neuropsychologist, my inpatient rehab team, and my outpatient rehab team, I am now back to working as a 911 dispatcher,” says Reyna. “I am even taking college courses, which helps my brain stay sharp, and I’m back to hiking and weight lifting too.” She recently celebrated her fifth wedding anniversary with a hiking trip to Zion National Park. Because of her experience, Reyna is a passionate advocate for encephalitis awareness. She shares her story with different medical and local community groups throughout Arizona in hopes of educating more people about encephalitis and the signs and symptoms of it, so others suffering from this devastating condition can get the help they need right away. “Encephalitis does have very high death rates from not getting treated properly, so if it wasn’t for Barrow, I might not be here today,” she says. Please join us in supporting the life-saving and life-changing patient care at Barrow by making a tax-deductible donation. Donate Now

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Introduction Early diagnosis and etiological treatment can effectively improve the prognosis of patients with autoimmune encephalitis (AE). However, anti-neuronal antibody tests which provide the definitive diagnosis require time and are not always abnormal.

Chronic psychiatric and behavioral problems remain present in one-third of children months to years after onset of AE.Larger scaled prospective observational studies with a consistent standardized battery of testing are needed to examine impact of specific clinical features and immunotherapies on...

Neuropsychiatric phenotypes of anti-NMDAR encephalitis: a prospective study...

Back in 2016, while training for a 100km walk, running my own Property Management business and doing temp work, I stressed my self out to the max.Working somewhere different each day meant continuously learning, I was training every weekend, trying to fundraise, and I started to go next level; making...

Autoimmune Encephalitis and Related Disorders of the Nervous System - February 2022...

The term ‘rapidly progressive dementia’ (RPD) describes a cognitive disorder with fast progression, leading to dementia within a relatively short time. This Review discusses the wide range of RPD aetiologies, as well as the diagnostic approach and treatment options.

Neurologists are often at the receiving end of the jokes of other medical specialists. They facetiously remark that neurologists know a lot, but do very little to cure their patients. Admittedly we do our fair share of dispensing weak platitudes, and we do break bad news with embarrassing...

University of Utah Health researchers are leading a five-year, $22-million nationwide clinical trial for NMDA receptor encephalitis––a type of autoimmune encephalitis that prompts the immune system to mistakenly attack the brain, causing confusion, memory loss, seizures, and symptoms similar to...

Sleep/wake disorders are common in patients with autoimmune encephalitis, sometimes the most prominent or sole initial symptom, then delaying diagnosis.Sleep/wake disorders in autoimmune encephalitis vary and include severe sleeplessness, hypersomnia, central and/or obstructive sleep apnea, rapid...

BackgroundAnti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is the most common type of autoimmune encephalitis. Early recognition and treatment, especially distinguishing from viral encephalitis (VE) in the early stages, are crucial for the outcomes of patients with anti-NMDAR...

Infectious etiologies and tumors are common triggers of autoimmune encephalitis. We herein reported a rare case of autoimmune encephalitis with multiple autoantibodies in cerebrospinal fluid (CSF) and serum, with concomitant human herpesvirus 7 (HHV-7) infection and ovarian teratoma.