[P1-111] Anti-N-Methyl-D-Aspartate Receptor Encephalitisin Children of Central-South China: Clinical Features, Treatment, Influencing Factors, and Outcomes
[Introduction] We analyzed the clinical manifestations of children with anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis in central-south China and the factors influencing the effectiveness of treatment.
[Methodology] A retrospective study of children with anti-NMDAR encephalitis in central-south China was carried out from March 2014 to February 2016. Demographics, clinical features, treatment, outcome, and the factors influencing the effectiveness of treatment were reviewed.
[Results] Thirty-seven patients with anti-NMDAR encephalitis were enrolled (median age, 8.5 years; 20 females). Thirty-three patients (89.2%) presented with psychiatric symptoms, 29 (78.4%) with dyskinesia and movement disorders, 27 (73%) with sleep disturbances, 25(67.6%) with seizures, 23 (62.2%) with a decreased level of consciousness (Glasgow score less than 15), 20 (54.1%) with speech disturbances, and nine (24.3%) with autonomic instability. None presented with hypoventilation. Only one patient (female, 14 years old) had an ovarian teratoma. All patients received first-line immunotherapy,19 patients received second-line immunotherapy, and only one patient accepted third-line immunotherapy. Thirty-two of the 37 patients achieved good outcomes (score on the modified Rankin Scale [MRS]of 0-2),while the other five had poor outcomes (MRS score of 3-5).
[Conclusions] This study investigated the clinical characteristics of children (aged 14or younger) with anti-NMDAR encephalitis in central-south China. Patients with decreased consciousness were more likely to have no or limited response to first-line immunotherapy and to require second-line or even more aggressive immunotherapy. Children with anti-NMDAR encephalitis in China have a much lower incidence of tumors, lower mortality rates, and a lower proportion of lethal autonomic instability than adults.
[Methodology] A retrospective study of children with anti-NMDAR encephalitis in central-south China was carried out from March 2014 to February 2016. Demographics, clinical features, treatment, outcome, and the factors influencing the effectiveness of treatment were reviewed.
[Results] Thirty-seven patients with anti-NMDAR encephalitis were enrolled (median age, 8.5 years; 20 females). Thirty-three patients (89.2%) presented with psychiatric symptoms, 29 (78.4%) with dyskinesia and movement disorders, 27 (73%) with sleep disturbances, 25(67.6%) with seizures, 23 (62.2%) with a decreased level of consciousness (Glasgow score less than 15), 20 (54.1%) with speech disturbances, and nine (24.3%) with autonomic instability. None presented with hypoventilation. Only one patient (female, 14 years old) had an ovarian teratoma. All patients received first-line immunotherapy,19 patients received second-line immunotherapy, and only one patient accepted third-line immunotherapy. Thirty-two of the 37 patients achieved good outcomes (score on the modified Rankin Scale [MRS]of 0-2),while the other five had poor outcomes (MRS score of 3-5).
[Conclusions] This study investigated the clinical characteristics of children (aged 14or younger) with anti-NMDAR encephalitis in central-south China. Patients with decreased consciousness were more likely to have no or limited response to first-line immunotherapy and to require second-line or even more aggressive immunotherapy. Children with anti-NMDAR encephalitis in China have a much lower incidence of tumors, lower mortality rates, and a lower proportion of lethal autonomic instability than adults.