PMID- 19364930
OWN - NLM
STAT- MEDLINE
DCOM- 20090424
LR  - 20090414
IS  - 1538-3687 (Electronic)
IS  - 0003-9942 (Linking)
VI  - 66
IP  - 4
DP  - 2009 Apr
TI  - Diagnostic value of N-methyl-D-aspartate receptor antibodies in women with 
      new-onset epilepsy.
PG  - 458-64
LID - 10.1001/archneurol.2009.5 [doi]
AB  - BACKGROUND: In women younger than 45 years, a new form of encephalitis associated 
      with ovarian teratoma and presenting with seizures and psychiatric symptoms has 
      been described. Most patients have antibodies to NR1/NR2 heteromers of the 
      N-methyl-D-aspartate receptor (NMDAR). OBJECTIVE: To assess the frequency and 
      significance of antibodies to NMDAR in otherwise unexplained new-onset epilepsies 
      in young women. DESIGN: Prospective cohort study. SETTING: University department 
      of epileptology. PATIENTS: From January 1, 2005, to June 30, 2007, we identified 
      19 female patients aged 15 to 45 years with unexplained new-onset epilepsy. In 
      addition, we studied 61 cerebrospinal fluid-serum sample pairs from patients with 
      other cryptogenic epilepsies and 11 cerebrospinal fluid-serum sample pairs from 
      surgically treated patients with epilepsy with no evident encephalitic 
      abnormalities. MAIN OUTCOME MEASURES: Antibodies to NMDAR and characteristics of 
      affected patients. RESULTS: Five of the 19 patients had antibodies against NMDAR. 
      These patients had diffuse cerebral dysfunction and seizure origins. Psychiatric 
      symptoms and pleocytosis were significantly associated with this group of 
      patients. The disease course was episodic, in part relapsing-remitting, with full 
      recoveries either spontaneously or after corticosteroid or intravenous 
      immunoglobulin treatments. Only 1 patient had a neoplasm (multiple neuroendocrine 
      tumors that included the ovaries) identified to date. In the control series, one 
      22-year-old man with a cryptogenic, severely encephalopathic seizure disorder was 
      NMDAR antibody positive, and he also recovered fully. CONCLUSIONS: Anti-NMDAR 
      encephalitis accounts for a relevant proportion of otherwise unexplained 
      new-onset epilepsies. Patients harboring NMDAR antibodies usually have prominent 
      psychiatric symptoms and pleocytosis, and they may develop hypoventilation. 
      Anti-NMDAR encephalitis is not always paraneoplastic.
FAU - Niehusmann, Pitt
AU  - Niehusmann P
AD  - Department of Epileptology, University of Bonn, Bonn, Germany.
FAU - Dalmau, Josep
AU  - Dalmau J
FAU - Rudlowski, Christian
AU  - Rudlowski C
FAU - Vincent, Angela
AU  - Vincent A
FAU - Elger, Christian E
AU  - Elger CE
FAU - Rossi, Jeffrey E
AU  - Rossi JE
FAU - Bien, Christian G
AU  - Bien CG
LA  - eng
GR  - 2R01CA89054-06A2/CA/NCI NIH HHS/United States
GR  - R01CA107192/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PL  - United States
TA  - Arch Neurol
JT  - Archives of neurology
JID - 0372436
RN  - 0 (Autoantibodies)
RN  - 0 (Potassium Channels, Voltage-Gated)
RN  - 0 (Receptors, N-Methyl-D-Aspartate)
RN  - EC 4.1.1.15 (Glutamate Decarboxylase)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Age Factors
MH  - Aged
MH  - Animals
MH  - Autoantibodies/*metabolism
MH  - Case-Control Studies
MH  - Diagnosis, Differential
MH  - Epilepsy/diagnosis/*immunology/pathology/surgery
MH  - Female
MH  - Glutamate Decarboxylase/immunology
MH  - Hippocampus/immunology/pathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Neuropil/immunology/pathology
MH  - Paraneoplastic Syndromes/diagnosis/immunology/pathology
MH  - Potassium Channels, Voltage-Gated/immunology
MH  - Rats
MH  - Rats, Wistar
MH  - Receptors, N-Methyl-D-Aspartate/*immunology
MH  - Reference Values
EDAT- 2009/04/15 09:00
MHDA- 2009/04/25 09:00
CRDT- 2009/04/15 09:00
PHST- 2009/04/15 09:00 [entrez]
PHST- 2009/04/15 09:00 [pubmed]
PHST- 2009/04/25 09:00 [medline]
AID - 66/4/458 [pii]
AID - 10.1001/archneurol.2009.5 [doi]
PST - ppublish
SO  - Arch Neurol. 2009 Apr;66(4):458-64. doi: 10.1001/archneurol.2009.5.