Bibliographic Details
| Title: |
Never Too Late to Treat NMDAR Encephalitis: A Paediatric Case Report and Review of Literature |
| Authors: |
Yisha Cheng, Dalya Chefitz, Vikram Bhise |
| Source: |
European Medical Journal Neurology, Pp 88-93 (2022) |
| Publisher Information: |
European Medical Journal, 2022. |
| Publication Year: |
2022 |
| Collection: |
LCC:Neurology. Diseases of the nervous system |
| Subject Terms: |
Neurology. Diseases of the nervous system, RC346-429 |
| More Details: |
Background: Anti-N-methyl-D-aspartate receptor antibody encephalitis is an immune-mediated disorder characterised by a complex neuropsychiatric syndrome that often can be initially misdiagnosed. A small subset of the population is refractory to both first- and second-line therapies. These reasons make delays to the correct therapy a major concern, as early treatment may lead to better outcomes in children. Nevertheless, there is still benefit in additional medication courses despite a prolonged refractory state. The authors provide an illustrative case report and review of literature. Case Presentation: The authors describe a 5-year-old female with 5 days of change in mental status; choreoathetoid movements were found to have positive anti-GluN1 antibodies in their cerebral spinal fluid. They failed first-line intravenous steroids and intravenous Ig and second-line rituximab, but then were discharged to rehabilitation without improvement over 3 months. Despite the time frame, they had a complete response to 12 sessions of plasma exchange with concomitant pulse steroids and subsequent intravenous Ig. Conclusion: The authors’ case report and review of literature supports practices that prompt additional therapy for incomplete or failure of response in anti-N-methyl-D-aspartate receptor encephalitis despite prolonged symptom duration. Extended plasma exchange therapy may be beneficial in some treatment refractory cases. |
| Document Type: |
article |
| File Description: |
electronic resource |
| Language: |
English |
| ISSN: |
2054-4529 |
| Relation: |
https://www.emjreviews.com/neurology/article/never-too-late-to-treat-nmdar-encephalitis-a-paediatric-case-report-and-review-of-literature-j110121/; https://doaj.org/toc/2054-4529 |
| DOI: |
10.33590/emjneurol/22-00096 |
| Access URL: |
https://doaj.org/article/25402868a90b42e7ba2f189aa3ddaa73 |
| Accession Number: |
edsdoj.25402868a90b42e7ba2f189aa3ddaa73 |
| Database: |
Directory of Open Access Journals |
