Little Children, Bigger Problems: Anti-N-Methyl D-Aspartate Receptor Encephalitis!
- 16 Downloads
Anti N-methyl D-aspartate receptor (NMDAR) antibody positive autoimmune encephalitis is a well-described entity both in adults as well as in children. The authors report an 18-mo-old boy who presented with seizures, movement disorder, cognitive impairment, and behavioral disturbances. Anti-NMDAR encephalitis was confirmed by detection of NMDAR antibodies in the cerebrospinal fluid. The patient was administered pulse corticosteroids and intravenous immunoglobulin followed by further immunomodulatory therapy. No tumor was detected on screening. The child remained unresponsive to treatment. The authors wish to highlight the occurrence of anti-NMDAR encephalitis in young toddlers and the poor response to therapy often seen in very young children.
KeywordsAnti-N-methyl D-aspartate NMDAR Autoimmune encephalitis Infant Encephalitis
The authors would like to acknowledge Dr. Naveen Sankhyan and Dr. S. Bhanudeep for their help in patient management.
AP, SK: Original draft of the manuscript; AGS, RS: Final revision of the manuscript; AM: Analysis of the antibody profile and approval of final version of the manuscript. Dr. Naveen Sankhyan, Head, Pediatric Neurology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh will act as guarantor for this paper.
Compliance with Ethical Standards
Conflict of Interest
- 4.Hilderink M, Titulaer MJ, Schreurs MWJ, Keizer K, Bunt JEH. Transient anti-NMDAR encephalitis in a newborn infant due to transplacental transmission. Neurol Neuroimmunol Neuroinflamm [Internet]. 2015 Jun 18. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4476049/. Accessed 13 Dec 2018.
- 7.Shin Y-W, Lee S-T, Park K-I, et al. Treatment strategies for autoimmune encephalitis. Therap Adv Neurol Disord. 2018;11:1–19.Google Scholar
- 9.Zhang Y, Liu G, Jiang M, Chen W, Su Y. Efficacy of therapeutic plasma exchange in patients with severe refractory anti-NMDA receptor encephalitis. Neurotherapeutics. 2019. https://doi.org/10.1007/s13311-019-00725-4.