[P1-22] Anti-N-Methyl-D-Aspartate Receptor Encephalitis in Children in Taiwan – Clinical Characteristics and Treatment Outcomes
[Introduction] Anti-N-methyl-D-aspartate receptor encephalitis is a potentially lethal disease that has a high probability for recovery if patients can be diagnosed early and properly treated. As this disease is notorious for its variable clinical presentations and most clinicians may not be familiar with this disease, a systemic analysis of patients’ clinical characteristics may help first-line clinicians understand this disease
[Methodology] We conducted a retrospective analysis of patients admitted to the Tungs’ Taichung MetroHarbor Hospital with confirmed anti-N-methyl-D-aspartate receptor encephalitis from 2010 to 2013. Their presenting symptoms, clinical features, laboratory and neuroimaging findings, and treatment outcomes were analyzed. Diagnosis was confirmed by anti-N-methyl-D-aspartate receptor antibodies in the cerebrospinal fluid.
[Results] Six patients (male: female: 1: 5) aged between 4 years and 13 years with anti-N-methyl-D-aspartate receptor encephalitis were identified. 83% (5/6) of the patients presented with mood, behavioral, or personality changes; 100% (6/6) had orofacial dyskinesia; 50% (3/6) had seizures; and 0% (0/6) had an underlying tumor. 33% of the patients received intravenous immunoglobulin. Overall, 66% of all patients made a substantial recovery with or without intravenous immunoglobulin (IVIG).
[Conclusions] Anti-N-methyl-D-aspartate receptor encephalitis is a treatable disease if the diagnosis is made early. Not all patients with this disease presented with psychosis. The prominent feature of patients with the disease was orofacial dyskinesia. IVIG treatment did not guarantee a favorable prognosis. Furthermore, some patients might have spontaneous recovery without IVIG treatment.
[Methodology] We conducted a retrospective analysis of patients admitted to the Tungs’ Taichung MetroHarbor Hospital with confirmed anti-N-methyl-D-aspartate receptor encephalitis from 2010 to 2013. Their presenting symptoms, clinical features, laboratory and neuroimaging findings, and treatment outcomes were analyzed. Diagnosis was confirmed by anti-N-methyl-D-aspartate receptor antibodies in the cerebrospinal fluid.
[Results] Six patients (male: female: 1: 5) aged between 4 years and 13 years with anti-N-methyl-D-aspartate receptor encephalitis were identified. 83% (5/6) of the patients presented with mood, behavioral, or personality changes; 100% (6/6) had orofacial dyskinesia; 50% (3/6) had seizures; and 0% (0/6) had an underlying tumor. 33% of the patients received intravenous immunoglobulin. Overall, 66% of all patients made a substantial recovery with or without intravenous immunoglobulin (IVIG).
[Conclusions] Anti-N-methyl-D-aspartate receptor encephalitis is a treatable disease if the diagnosis is made early. Not all patients with this disease presented with psychosis. The prominent feature of patients with the disease was orofacial dyskinesia. IVIG treatment did not guarantee a favorable prognosis. Furthermore, some patients might have spontaneous recovery without IVIG treatment.