Clinical analysis of 10 patients with anti-N-methyl-D-aspartate receptor encephalitis

Abstract

Objective To analyze the clinical feature of the patients with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis and feature of brain MRI and electroencephalogram (EEG) in children. Methods We reviewed the clinical manifestations, brain MRI and EEG features of 10 patients who were diagnosed anti-NMDAR encephalitis. Results Of the 10 patients, 3 cases were male and 7 cases were female.The age was ranged from 13 months to 14 years (6 years and 11 months on average). No tumor was found in those patients.Main symptoms included seizure in 9 cases, psychiatric symptoms in 10 cases, consciousness disturbance in 4 cases, involuntary movements in 8 cases, autonomic nerve instability in 5 cases, and sleep disorders in 10 cases.7 patients of MRI examination were normal, 2 patients revealed abnormal signal of temporal lobe, frontal, and parietal cortex.One patient revealed brain atrophy.All patients had abnormal EEG with diffusive slow waves, and some with focal spikes or sharp waves, left side abnormal more than right side. Conclusion Anti-NMDAR encephalitis can be found in children, even young boys may be affected.They have a lower incidence of tumors.Its predominant clinical features are psychiatrics symptoms, seizures, involuntary movements and consciousness alteration.EEG was considered more significant than brain MRI. Key words: N-methyl-D-aspartate receptor; Encephalitis