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We are Anti NMDA Receptor Encephalitis! | We are Anti NMDA Receptor Encephalitis!

We are Anti NMDA Receptor Encephalitis!  | We are Anti NMDA Receptor Encephalitis! | AntiNMDA | Scoop.it
The Anti-NMDA Receptor Encephalitis Foundation, Inc.was established in Canada as a not-for profit-foundation on 26 October 201...
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We are Anti NMDA Receptor Encephalitis! | We are Anti NMDA Receptor Encephalitis!

We are Anti NMDA Receptor Encephalitis!  | We are Anti NMDA Receptor Encephalitis! | AntiNMDA | Scoop.it
The Anti-NMDA Receptor Encephalitis Foundation, Inc.was established in Canada as a not-for profit-foundation on 26 October 201...
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RACGP - Old doc, new disease: Anti-NMDA receptor encephalitis

RACGP - Old doc, new disease: Anti-NMDA receptor encephalitis | AntiNMDA | Scoop.it
COLUMN Old doc, new disease: Anti-NMDA receptor encephalitis Dr Casey Parker reflects on an intriguing presentation that made him ask: What else do I not know? It turns out Paul’s mother was right.   The first time I saw him, Paul seemed to have a post-viral malaise. A head cold that lingered, a low mood and lethargy.   His second visit two weeks later, however, left me confused. Paul seemed odd. Mumbling, disorganised and suspicious. I was concerned. This looked like an emerging psychosis, but there was nothing firm enough upon which to act.   Paul’s mum was also worried. She could sense that something was seriously awry in her son’s mind. So I did another examination, which also proved fruitless.   Paul seemed completely normal in many ways, but not in others. He had been doing his engineering exams a just month ago, but he was now struggling to do simple maths.   I ordered a batch of bloods and a brain scan in desperation, and resolved to see Paul in a few days. If the investigations were not illuminating then he would need to go in for assessment by the mental health team.   The CT scan, as it turned out, was pristine. When I phoned Paul’s mother to deliver the ‘good news’, she did not seem reassured. She then mentioned that Paul was displaying increasingly paranoid behaviour; she suspected he was hearing voices. I agreed to see him in the morning.   The bloods were all normal, besides a C-reactive protein (CRP) creep. When I told her about my concerns regarding Paul’s mental health, his mother was disbelieving. ‘No, he isn’t mad. There is something wrong with his brain,’ she insisted.   She was right.   Paul never returned for his appointment that week. He suffered a seizure in the night and an ambulance took him to the emergency department. After a long barrage of sedation, testing and imaging, he was eventually seen by the neurologist, who made the diagnosis. The answer was hiding in Paul’s cerebrospinal fluid – a rare condition first described in 2007.   Anti-NMDA receptor encephalitis is an autoimmune process, in which antibodies against the NMDA (N-methyl-D-aspartate) receptors are produced. About 80% of female patients with the condition have an ovarian teratoma that is thought to be the site of the extra-cerebral tissue that triggers the immune system to attack the brain.   The inflammation occurs in the limbic system, particularly the mesolimbus, hippocampus and dorsolateral prefrontal cortex. The autonomic system is involved later in the disease, resulting in unstable cardiovascular and respiratory function.   While lesser known, anti-NMDA encephalitis is more common than viral encephalitis in young people, and women are four times more likely to develop the syndrome. Those that have coexisting teratomas have a good prognosis if diagnosed early.   Initial treatment involves immunosuppressive therapy with steroids. Screening for and surgical removal of any teratomas should be a priority. Second line therapies include intravenous immunoglobulin or immunotherapy with agents such as rituximab.   One curious aspect about this syndrome is that it is palindromic – that is, the symptoms reappear in reverse order as the treatment is maintained.   As such, patients may paradoxically redevelop psychotic symptoms after initiating steroids due to unopposed dopaminergic activity. Resolution generally occurs over a period of months. Some patients will not make a full recovery – approximately 10–15% will experience a recurrence.   Paul’s case was an important one for me. You cannot diagnose what you do not know. My ignorance of this condition made me question my practice.   What else do I not know?   Although anti-NMDA encephalitis is a rare diagnosis, it is commonly misdiagnosed. A missed case has potentially tragic outcomes for a healthy young person. If he has been undiagnosed, Paul would have been exposed to harmful antipsychotic medications. He may have spiraled into a coma with loss of precious function.   So next time you see a young person with emerging psychotic symptoms ask yourself: could it be? disease encephalitis NMDA receptor
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Link between HLA alleles and anti-NMDAR encephalitis

Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is one of the major types of antibody-mediated autoimmune encephalitis. It was originally reported to be highly prevalent in young women with ovarian teratoma, but later studies found that the cases were not limited to young women with...
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Rectifying neurologic diagnosis through autoantibodies

Rectifying neurologic diagnosis through autoantibodies | AntiNMDA | Scoop.it
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Tools that improve our ability to provide patients with a speedy and accurate diagnosis can come in many forms, and I have chosen several articles in this issue of N2 to highlight this point.
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The Anti-NMDA Receptor Encephalitis Foundation Newsletter

The Anti-NMDA Receptor Encephalitis Foundation Newsletter | AntiNMDA | Scoop.it
We are Anti NMDA Receptor Encephalitis! | We are Anti NMDA Receptor Encephalitis!From...
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Long-term seizure outcome in patients with status epilepticus due to acute encephalitis | MyNeuroNews

Encephalitis is swelling and inflammation of the brain, which can be caused by infectious or autoimmune aetiologies.Up to 18.5% to 40.4% of patients were reported to develop status epilepticus (SE) d...
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Treating the brain and the immune system in tandem

Treating the brain and the immune system in tandem | AntiNMDA | Scoop.it
Scientists are now recognizing that a host of external stimuli can disrupt the normal crosstalk between the brain and the immune system...
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Anti-N-methyl-D-aspartate receptor encephalitis mimics neuroleptic mal | NDT

Anti-N-methyl-D-aspartate receptor encephalitis mimics neuroleptic mal | NDT | AntiNMDA | Scoop.it
Anti-N-methyl-D-aspartate receptor encephalitis mimics neuroleptic malignant syndrome: case report and literature review...
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Friends launch fundraiser to get Edinburgh man’s body back home to heartbroken mum - Edinburgh Evening News

Friends launch fundraiser to get Edinburgh man’s body back home to heartbroken mum - Edinburgh Evening News | AntiNMDA | Scoop.it
A fundraiser has been launched to help bring the body of an Edinburgh man who died in a foreign hospital back home to his heartbroken mother.
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Anti-NMDAR encephalitis preceded by non-herpetic central nervous system infection: Systematic literature review and first case of tick-borne encephalitis triggering anti-NMDAR encephalitis

Anti-NMDAR encephalitis preceded by non-herpetic central nervous system infection: Systematic literature review and first case of tick-borne encephalitis triggering anti-NMDAR encephalitis | AntiNMDA | Scoop.it
After the recent description of biphasic disease with herpes simplex virus (HSV) encephalitis
followed by anti-N-methyl-d-aspartate receptor encephalitis (anti-NMDARE), anti-NMDARE
preceded by non-HSV central nervous system (CNS) infection has been more rarely reported.
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A transdiagnostic pattern of psychiatric symptoms in autoimmune encephalitis

A transdiagnostic pattern of psychiatric symptoms in autoimmune encephalitis | AntiNMDA | Scoop.it
(The Lancet Psychiatry) – N-methyl-D-aspartate receptor (NMDAR)-antibody encephalitis is a neuropsychiatric disorder1, 2 that is caused by antibodies against the NR1 subunit of the NMDA receptor. Many patients with NMDAR-antibody encephalitis are...
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Thank you and Congratulations – Travel Award Recipient

Thank you and Congratulations – Travel Award Recipient | AntiNMDA | Scoop.it
The Foundation would like to thank all those neurology and psychiatry trainees who applied for the Foundation’s Travel award to attend the Symposium titled Autoimmune ...Read More...
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Converging themes in neurology and psychiatry

Converging themes in neurology and psychiatry | AntiNMDA | Scoop.it
This exciting event will update participants on current clinical and basic research in a variety of disorders at the interface of neurology and psychiatry.
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Anti-nmda receptor encephalitis complicating hsv encephalitis with demonstrated seroconversion

Anti-nmda receptor encephalitis complicating hsv encephalitis with demonstrated seroconversion | AntiNMDA | Scoop.it
Objectives A case of anti-NMDA receptor antibody encephalitis seen at a tertiary neurology centre complicating initial herpes simplex virus encephalitis (HSVE) is presented. HSVE is the most frequent fatal encephalitis in western countries with 35% of patients affected by this condition suffering...
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GABAA receptor autoimmunity

GABAA receptor autoimmunity | AntiNMDA | Scoop.it
Objective We sought to validate methods for detection and confirmation of GABAA receptor (R)-IgG and clinically characterize seropositive cases.

Methods Archived serum and CSF specimens (185 total) suspected to harbor GABAAR-IgG were evaluated by indirect immunofluorescence assay (IFA).
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Serum and CSF neurofilament light chain levels in antibody-mediated encephalitis

Serum and CSF neurofilament light chain levels in antibody-mediated encephalitis | AntiNMDA | Scoop.it
Circulating and cerebrospinal fluid (CSF) neurofilament light chain (NfL) levels represent a reliable indicator of disease activity and axonal damage in different neuroinflammatory conditions....
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Autoantibodies against Neurologic Antigens in Nonneurologic Autoimmunity

Autoantibodies against Neurologic Antigens in Nonneurologic Autoimmunity | AntiNMDA | Scoop.it
The aim of this study was to test whether autoantibodies against neurologic surface Ags are found in nonneurologic autoimmune diseases, indicating a broader loss of tolerance. Patient and matched healthy donor (HD) sera were derived from four large cohorts: 1) rheumatoid arthritis (RA) ( n = 194,...
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Revolutionizing the Diagnosis of Autoimmune Diseases

Revolutionizing the Diagnosis of Autoimmune Diseases | AntiNMDA | Scoop.it
Small questions don’t hold much appeal for Drs. Samuel Pleasure and Michael Wilson, Department of Neurology, and Joseph DeRisi, Department of Biochemistry and Biophysics. The talented trio is much more interested in tackling the really big problems, like getting to the root of the mysterious and sometimes deadly illnesses that puzzle even the most seasoned clinicians. Perhaps it’s no surprise that Drs. DeRisi, Pleasure, and Wilson’s latest project is especially ambitious. Together, they aim to develop a single test to diagnose any form of autoimmune encephalitis – a category of illness characterized by brain inflammation that is notoriously difficult to detect. The first-line test could be integrated into hospitals around the country, helping clinicians garner a diagnosis within 24 to 48 hours. The foundation for this work: “Along with other colleagues at UCSF, we’ve collected samples from hundreds of patients with mysterious causes of brain inflammation. Using a sequencing test developed by the team, we can now identify the singular cause of any infection – viral, bacterial, parasitic, or fungal. This development has led to lifesaving diagnoses for patients.” Michael Wilson Some patients remain a mystery: “Three or four times a month, we get a patient who has something that absolutely no one understands. Many of these patients are on a multitude of anti-infective drugs – antivirals, antibacterials – really everything but the kitchen sink. They come to us because they have nowhere else to turn.” Samuel Pleasure A tool to change it all: “What we don’t have is a tool that lets us say, ‘Well, it’s not infectious, it’s clearly autoimmune, and it’s B-cell driven’ or ‘It’s T-cell driven.’ A diagnostic test could be used in the clinic to guide a patient down one treatment path or another. If you know what you’re dealing with, you can make smart clinical decisions more quickly and ensure better outcomes for patients.” Samuel Pleasure How the test might work: “We would use sequencing and antibodies from the patients’ cerebrospinal fluid to search for gene expression patterns and antibody reactivity that would help categorize whether the patient is suffering from an infectious or autoimmune process.” Samuel Pleasure Why philanthropy matters: “It makes our work go at a much faster pace, and it obviates the lengthy – and sometimes completely unnecessary – cycle of grant applications and review. This kind of work is risky, but its impact is potentially huge.” Joseph DeRisi Why do this work at UCSF: We have a unique structure here that really blends basic sciences and clinical science. The departmental labels don’t mean much here, and the artificial barriers that traditional departmental structures create are absent. We’re also all physically close. There are three or four departments housed in my work neighborhood alone.” Joseph DeRisi
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Neurology® Podcast: Practice Current: Autoimmune Encephalitis & the Role of Antibody Testing

Neurology® Podcast: Practice Current: Autoimmune Encephalitis & the Role of Antibody Testing | AntiNMDA | Scoop.it
Dr. Luca Bartolini discusses autoimmune encephalitis and the role of antibody testing based on a Practice Current survey run between November 2017 and May 2018....
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Transient Dyschromatopsia, Static Form Agnosia, and Prosopagnosia Observed in a Patient with Anti-NMDA Receptor Encephalitis

Transient Dyschromatopsia, Static Form Agnosia, and Prosopagnosia Observed in a Patient with Anti-NMDA Receptor Encephalitis | AntiNMDA | Scoop.it
Case Reports in Neurological Medicine is a peer-reviewed, Open Access journal that publishes case reports and case series focusing on diseases of the nervous system, as well as abnormal neurological function.
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Autoimmune Encephalitis in Postpartum Psychosis

Autoimmune Encephalitis in Postpartum Psychosis | AntiNMDA | Scoop.it
Significant immunological alterations have been observed in women with first-onset affective psychosis during the postpartum period. Recent studies have highlighted the possibility that a subset of patients with first-onset severe psychiatric episodes ...
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Development of the clinical assessment scale in autoimmune encephalitis. - PubMed - NCBI

Development of the clinical assessment scale in autoimmune encephalitis. - PubMed - NCBI | AntiNMDA | Scoop.it
Ann Neurol. 2019 Jan 24. doi: 10.1002/ana.25421.[Epub ahead of print]...
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New Study: Sleep Disturbances in Autoimmune Encephalitis

New Study: Sleep Disturbances in Autoimmune Encephalitis | AntiNMDA | Scoop.it
Seizures and movement disorders are very common in anti-NMDA receptor encephalitis, as well as other forms of autoimmune encephalitis (AE) and researchers have undertaken to ...Read More...
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Paraneoplastic Teratoma-associated Anti-N-Methyl-D-Aspartate Receptor Encephalitis: The First Published Report from Saudi Arabia. - PubMed - NCBI

Cureus. 2018 Oct 31;10(10):e3527. doi: 10.7759/cureus.3527.
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