[P1-113] Findings of continuous EEG in pediatric patients with anti-NMDA receptor encephalitis.
[Objective] To determine the findings of continuous EEG in series of pediatric patients with anti-NMDA receptor encephalitis.
[Method] Evaluation of clinical presentation, continuous EEG findings and outcome of six patients who were admitted to King Chulalongkorn Memorial Hospital from January, 1st 2011 to December, 31st 2015.
[Result] Six patients were admitted to King Chulalongkorn Memorial Hospital during the study period. Mean age was 8 years old (range 5-13). Mean length of hospitalization was 75 days (range 6-150). Clinical presentations were behavioral change (100%), lip smacking (100%), sleep disturbance (100%) and seizure (67%). EEG findings shown focal or generalized encephalopathy (100%), focal epileptiform discharges (50%) and extreme delta brush (83%). Only one in six patient without extreme delta brush was a six years old boy who presented with abnormal movement and behavioral change only. Extreme delta brushes were seen in EEG recorded while the patients were in coma or in status epilepticus. The range of frequency were 19-31 Hz. No tumor or underlying causes were found in any patients. All patients were treated with intravenous immunoglobulin and intravenous methylprednisolone. Five of six patients (83%) were treated with pulse cyclophosphamide monthly for six to nine months. Two patients (33%) were clinically improved, three patients (50%) were not improved and one patient (13%) has recurrent attack.
[Conclusion] EEG findings in anti-NMDA receptor encephalitis including encephalopathy, epileptiform discharge and extreme delta brush. When patients present with encephalopathy and extreme delta brushes were found in the EEG, diagnosis of anti-NMDA receptor encephalitis should be considered.
[Method] Evaluation of clinical presentation, continuous EEG findings and outcome of six patients who were admitted to King Chulalongkorn Memorial Hospital from January, 1st 2011 to December, 31st 2015.
[Result] Six patients were admitted to King Chulalongkorn Memorial Hospital during the study period. Mean age was 8 years old (range 5-13). Mean length of hospitalization was 75 days (range 6-150). Clinical presentations were behavioral change (100%), lip smacking (100%), sleep disturbance (100%) and seizure (67%). EEG findings shown focal or generalized encephalopathy (100%), focal epileptiform discharges (50%) and extreme delta brush (83%). Only one in six patient without extreme delta brush was a six years old boy who presented with abnormal movement and behavioral change only. Extreme delta brushes were seen in EEG recorded while the patients were in coma or in status epilepticus. The range of frequency were 19-31 Hz. No tumor or underlying causes were found in any patients. All patients were treated with intravenous immunoglobulin and intravenous methylprednisolone. Five of six patients (83%) were treated with pulse cyclophosphamide monthly for six to nine months. Two patients (33%) were clinically improved, three patients (50%) were not improved and one patient (13%) has recurrent attack.
[Conclusion] EEG findings in anti-NMDA receptor encephalitis including encephalopathy, epileptiform discharge and extreme delta brush. When patients present with encephalopathy and extreme delta brushes were found in the EEG, diagnosis of anti-NMDA receptor encephalitis should be considered.