Anti-N-methyl-d-aspartate receptor encephalitis in a pre-teenage girl: a case report
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Anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis is an auto-immune and paraneoplastic encephalitis which generally affects young adults. It is a multistage illness, with prominent extrapyramidal, neuropsychiatric and autonomic symptoms. The syndrome is frequently associated with an ovarian teratoma. Recently, it has become evident that anti-NMDAR encephalitis is more common in children and adolescents than was previously believed. Prognostic factors that determine a good outcome are presence of a tumour, prompt treatment and no need for admission to an intensive care unit. Increased awareness among paediatricians of this potentially life-threatening disease is important because early recognition and treatment will improve the patients’ chances of a good clinical outcome. In this case report, we describe a 9-year-old girl with behavioural changes and severe extrapyramidal symptoms due to anti-NMDAR encephalitis associated with an ovarian teratoma. She was treated with a variety of immunomodulating therapies and made a slow, but good recovery.
KeywordsAnti-N-methyl-d-aspartate receptor Encephalitis Teratoma Children
Paediatric intensive care unit
The parents of the patient gave informed consent for publication of this case report.
Conflict of Interest
The authors declare that they have no competing interests.
- 1.Dalmau J, Tuzun E, Wu HY, Masjuan J, Rossi JE, Voloschin A, Baehring JM, Shimazaki H, Koide R, King D, Mason W, Sansing LH, Dichter MA, Rosenfeld MR, Lynch DR (2007) Paraneoplastic anti-N-methyl-d-aspartate receptor encephalitis associated with ovarian teratoma. Ann Neurol 61(1):25–36PubMedCentralPubMedCrossRefGoogle Scholar
- 5.Gable MS, Sheriff H, Dalmau J, Tilley DH, Glaser CA (2012) The frequency of autoimmune N-methyl-d-aspartate receptor encephalitis surpasses that of individual viral etiologies in young individuals enrolled in the California Encephalitis Project. Clin Infect Dis 54(7):899–904PubMedCentralPubMedCrossRefGoogle Scholar
- 8.Titulaer MT, McCracken L, Gabilondo I, Armangué T, Glaser C, Iizuka T, Honig LS, Benseler SM, Kawachi I, Martinez-Hernandez E, Aguilar E, Gresa-Arribas N, Ryan-Florance N, Torrents A, Saiz A, Rosenfeld MR, Balice-Gordon R, Graus F, Dalmau J (2013) Treatment and prognostic factors for long-term outcome in patients with anti-NMDA receptor encephalitis: an observational cohort study. Lancet Neurol 12:157–165PubMedCentralPubMedCrossRefGoogle Scholar