Study finds Clinical features and outcomes of anti-N-methyl-
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A Study was conducted to describe the clinical features and outcomes of anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis in infants and toddlers.

This was a single-center retrospective study. Infants and toddlers who met the diagnostic criteria for anti-NMDAR encephalitis were recruited for the study. Data on clinical features, treatment, and long-term outcomes were collected retrospectively. A total of 41 patients (age range: 6 to 34 months; median age: 23 months; female: 19 were enrolled in this study.


Results:
--19 of the patients exhibited classical anti-NMDAR encephalitis, while 22 patients exhibited anti-NMDAR encephalitis after viral encephalitis.

--There was a high presentation of movement disorders (100%), developmental regression (90%), abnormal behaviors (90%), sleep disorders (80%), and seizures (68%). However, neoplasms were not detected.

--All patients were administered first-line therapy (glucocorticoids, intravenous immunoglobulin, alone or combined), with only 17% of them being administered second-line immunotherapy.

--40 patients were followed up. 2 patients succumbed to the disease, while none of them showed relapse.

--At the long-term follow-up (more than 1 year), 20/35 exhibited satisfactory outcomes.

--Compared with classical anti-NMDAR encephalitis patients (n=18), patients after viral encephalitis (n=17) were more likely to have worse clinical outcomes. They exhibited a higher mRS/PCPC score and more frequent seizures. A predictor of poor outcome was presentation after viral encephalitis (OR 35.7).

Finally, anti-NMDAR encephalitis occurs clinically in infants and toddlers as movement abnormalities, developmental regression, and irregular behaviors. Surprisingly, this category had a higher percentage of patients that had viral encephalitis, which is thought to be the sole cause of bad outcomes.

Source: https://www.sciencedirect.com/science/article/abs/pii/S0887899421000291?dgcid=rss_sd_all
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