Evaluation of the Anti-N-Methyl-D-Aspartate Receptor Encephalitis One-Year Functional Status Score in Predicting Functional Outcomes in Pediatric Patients with Anti-N-Methyl-D-Aspartate Receptor Encephalitis

Abstract

Anti-N-methyl-D-aspartate receptor encephalitis (NMDARE) is an autoimmune neurological condition associated with autoantibodies to the N-methyl-D-aspartate (NMDA) receptor; it is a common cause of pediatric encephalitis. 1 Gable M.S. Sheriff H. Dalmau J. Tilley D.H. Glaser C.A. 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. 2012; 54: 899-904 Crossref PubMed Scopus (490) Google Scholar Presenting symptoms include behavioral disturbances, seizures, movement disorders, speech dysfunction, and altered consciousness and can lead to persistent neuropsychiatric deficits in children. 2 Titulaer M.J. McCracken L. Gabilondo I. et al. Treatment and prognostic factors for long-term outcome in patients with anti-NMDA receptor encephalitis: an observational cohort study. Lancet Neurol. 2013; 12: 157-165 Abstract Full Text Full Text PDF PubMed Scopus (1760) Google Scholar ,3 Wang Y. Zhang W. Yin J. et al. Anti-N-methyl-d-aspartate receptor encephalitis in children of Central South China: clinical features, treatment, influencing factors, and outcomes. J Neuroimmunol. 2017; 312: 59-65 Abstract Full Text Full Text PDF PubMed Scopus (34) Google Scholar Long-term outcomes are challenging to predict but are important for prognostication and guiding early management because early and aggressive immunotherapy may improve outcomes. 1 Gable M.S. Sheriff H. Dalmau J. Tilley D.H. Glaser C.A. 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. 2012; 54: 899-904 Crossref PubMed Scopus (490) Google Scholar ,2 Titulaer M.J. McCracken L. Gabilondo I. et al. Treatment and prognostic factors for long-term outcome in patients with anti-NMDA receptor encephalitis: an observational cohort study. Lancet Neurol. 2013; 12: 157-165 Abstract Full Text Full Text PDF PubMed Scopus (1760) Google Scholar ,4 Gerstle K. Hur M.H. Moussa T. Pediatric anti-NMDA-R encephalitis: presentation, diagnosis, and management. Pediatr Ann. 2019; 48: e387-e390 Crossref PubMed Scopus (3) Google Scholar Developed to predict one-year outcomes in NMDARE, the NMDARE One-Year Functional Status (NEOS) score strongly predicts the probability of good functional outcomes. 5 Balu R. McCracken L. Lancaster E. Graus F. Dalmau J. Titulaer M.J. A score that predicts 1-year functional status in patients with anti-NMDA receptor encephalitis. Neurology. 2019; 92: e244-e252 Crossref PubMed Scopus (100) Google Scholar However, the applicability of this tool has not yet been evaluated in a pediatric NMDARE cohort. This study aims to evaluate the NEOS score to predict one-year functional outcomes in patients with pediatric NMDARE.