PMID- 33818179
OWN - NLM
STAT- MEDLINE
DCOM- 20220314
LR  - 20220314
IS  - 1708-8283 (Electronic)
IS  - 0883-0738 (Linking)
VI  - 36
IP  - 9
DP  - 2021 Aug
TI  - Pediatric N-Methyl-d-Aspartate (NMDA) Receptor Encephalitis, With and Without 
      Herpes Encephalitis.
PG  - 743-751
LID - 10.1177/08830738211002679 [doi]
AB  - OBJECTIVE: To compare clinical, diagnostic, management, and outcome factors in 
      children with anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis and a 
      history of herpes simplex encephalitis (HSE) to children with NMDAR encephalitis 
      without a history of HSE. METHODS: All patients with anti-NMDAR antibodies in 
      cerebrospinal fluid treated at our institution between 2012 and 2019 were 
      identified and divided into those with a history of HSE (HSE+NMDAR group) and 
      those without a history of HSE (NMDAR-only group). Demographic data, clinical 
      characteristics, immunotherapy, and outcome data were collected on all patients 
      and compared between the 2 groups. RESULTS: Seventeen patients were identified 
      with anti-NMDAR antibodies in cerebrospinal fluid, 6 of whom had a history of 
      HSE. Mean age in the HSE+NMDAR cohort was significantly younger in the HSE+NMDAR 
      cohort, as 5 of the 6 patients were infants. Of HSE+NMDAR patients, 50% had 
      behavioral symptoms, 67% had movement disorders, and 100% had seizures at disease 
      nadir. In the NMDAR-only group, 100% had behavioral symptoms, 73% had movement 
      disorders, and 73% had seizures at nadir. HSE+NMDAR patients received a median of 
      1 immunotherapy, compared to a median of 4.5 immunotherapies in the NMDAR-only 
      group. CONCLUSION: Behavioral symptoms were more common in NMDAR-only patients, 
      whereas seizures were more common in HSE+NMDAR patients. Both groups had 
      significant disability at disease nadir, with more improvement in disability over 
      time in the NMDAR-only group. HSE+NMDAR patients received fewer immunotherapies 
      than NMDAR-only patients. Outcomes of infants with HSE appear to primarily 
      reflect sequelae from HSE.
FAU - Marcus, Lydia
AU  - Marcus L
AUID- ORCID: 0000-0003-2725-2825
AD  - Division of Pediatric Neurology, Department of Pediatrics, Children's Hospital of 
      Alabama, 9968University of Alabama at Birmingham, Birmingham, AL, USA.
FAU - Ness, Jayne M
AU  - Ness JM
AD  - Division of Pediatric Neurology, Department of Pediatrics, Children's Hospital of 
      Alabama, 9968University of Alabama at Birmingham, Birmingham, AL, USA.
LA  - eng
PT  - Journal Article
DEP - 20210405
PL  - United States
TA  - J Child Neurol
JT  - Journal of child neurology
JID - 8606714
RN  - 0 (Immunologic Factors)
RN  - 6384-92-5 (N-Methylaspartate)
SB  - IM
MH  - Anti-N-Methyl-D-Aspartate Receptor 
      Encephalitis/*diagnosis/*etiology/physiopathology
MH  - Case-Control Studies
MH  - Causality
MH  - Child
MH  - Child, Preschool
MH  - Encephalitis, Herpes Simplex/*complications/epidemiology/physiopathology
MH  - Female
MH  - Humans
MH  - Immunologic Factors/therapeutic use
MH  - Infant
MH  - Male
MH  - N-Methylaspartate
MH  - Outcome Assessment, Health Care/methods/statistics & numerical data
OTO - NOTNLM
OT  - NMDA receptor antibody
OT  - encephalitis
OT  - herpes
OT  - pediatric
EDAT- 2021/04/06 06:00
MHDA- 2022/03/15 06:00
CRDT- 2021/04/05 12:19
PHST- 2021/04/06 06:00 [pubmed]
PHST- 2022/03/15 06:00 [medline]
PHST- 2021/04/05 12:19 [entrez]
AID - 10.1177/08830738211002679 [doi]
PST - ppublish
SO  - J Child Neurol. 2021 Aug;36(9):743-751. doi: 10.1177/08830738211002679. Epub 2021 
      Apr 5.