Clinical characteristics, treatment and long-term prognosis in patients with anti-NMDAR encephalitis.
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| Title: | Clinical characteristics, treatment and long-term prognosis in patients with anti-NMDAR encephalitis. |
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| Authors: | Raja, Pritam (AUTHOR), Shamick, Biswas (AUTHOR), Nitish, L. K. (AUTHOR), Holla, Vikram Venkappayya (AUTHOR), Pal, P. K. (AUTHOR), Mahadevan, Anita (AUTHOR), Thomas, Priya Treesa (AUTHOR), Maya, Bhat (AUTHOR), Saini, J. (AUTHOR), Shantala, H. (AUTHOR), Netravathi, M. (AUTHOR) |
| Source: | Neurological Sciences. Nov2021, Vol. 42 Issue 11, p4683-4696. 14p. 1 Color Photograph, 2 Black and White Photographs, 7 Charts. |
| Subjects: | Child patients, Prognosis, Anti-NMDA receptor encephalitis, Encephalitis, Adults, Disease relapse, Gender |
| Abstract: | Objectives: We aimed to (i) analyse the clinical characteristics, treatment outcome and long-term prognosis of anti-NMDAR encephalitis and (ii) study the differences between paediatric and adult patients. Methods: This was a chart review of all patients with anti-NMDAR encephalitis. Results: There were 28 patients with 18 patients belonging to the paediatric (<18 years) age group. There was female (94%) preponderance in the paediatric age group, while in adult patients, there was no gender predilection (p=0.006). There was no significant difference in clinical feature, outcome or number of relapses between paediatric and adult population groups. MRI brain was abnormal in 53% of patients. Among the 15 patients with MRI abnormalities at the onset, 53% had poor functional outcome at 1 year, while in 12 patients with normal initial MRI brain, only 8% had poor functional outcome at 1 year (p =0.01). Nearly 53% of patients with abnormal MRI at presentation had at least one clinical relapse within 2 years while in patients with normal MRI at presentation, 15% had a clinical relapse (p=0.037). EEG abnormalities were noticed in 71% of patients; among them, 40 and 15% had poor functional outcome at 1 and 2 years respectively. In comparison, those with normal first EEG at onset, 12% had poor functional outcome at 2 years (p=0.57). Conclusions: Both paediatric and adult patients presented with similar clinical features but the paediatric population had female preponderance. The functional outcome and number of relapse were comparable in both the paediatric and adult groups. Patients with parenchymal changes on MRI and abnormal EEG showed poorer response compared to those with normal MRI and/or EEG at the onset. Patients have lesser severity of symptoms at relapse than in the first episode. An early diagnosis and treatment are essential for better long-term functional outcome. [ABSTRACT FROM AUTHOR] |
| Copyright of Neurological Sciences is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Psychology and Behavioral Sciences Collection |
| FullText | Links: – Type: pdflink Text: Availability: 0 |
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| Header | DbId: pbh DbLabel: Psychology and Behavioral Sciences Collection An: 153079858 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Clinical characteristics, treatment and long-term prognosis in patients with anti-NMDAR encephalitis. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Raja%2C+Pritam%22">Raja, Pritam</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Shamick%2C+Biswas%22">Shamick, Biswas</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Nitish%2C+L%2E+K%2E%22">Nitish, L. K.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Holla%2C+Vikram+Venkappayya%22">Holla, Vikram Venkappayya</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Pal%2C+P%2E+K%2E%22">Pal, P. K.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Mahadevan%2C+Anita%22">Mahadevan, Anita</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Thomas%2C+Priya+Treesa%22">Thomas, Priya Treesa</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Maya%2C+Bhat%22">Maya, Bhat</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Saini%2C+J%2E%22">Saini, J.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Shantala%2C+H%2E%22">Shantala, H.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Netravathi%2C+M%2E%22">Netravathi, M.</searchLink> (AUTHOR) – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Neurological+Sciences%22">Neurological Sciences</searchLink>. Nov2021, Vol. 42 Issue 11, p4683-4696. 14p. 1 Color Photograph, 2 Black and White Photographs, 7 Charts. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Child+patients%22">Child patients</searchLink><br /><searchLink fieldCode="DE" term="%22Prognosis%22">Prognosis</searchLink><br /><searchLink fieldCode="DE" term="%22Anti-NMDA+receptor+encephalitis%22">Anti-NMDA receptor encephalitis</searchLink><br /><searchLink fieldCode="DE" term="%22Encephalitis%22">Encephalitis</searchLink><br /><searchLink fieldCode="DE" term="%22Adults%22">Adults</searchLink><br /><searchLink fieldCode="DE" term="%22Disease+relapse%22">Disease relapse</searchLink><br /><searchLink fieldCode="DE" term="%22Gender%22">Gender</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Objectives: We aimed to (i) analyse the clinical characteristics, treatment outcome and long-term prognosis of anti-NMDAR encephalitis and (ii) study the differences between paediatric and adult patients. Methods: This was a chart review of all patients with anti-NMDAR encephalitis. Results: There were 28 patients with 18 patients belonging to the paediatric (<18 years) age group. There was female (94%) preponderance in the paediatric age group, while in adult patients, there was no gender predilection (p=0.006). There was no significant difference in clinical feature, outcome or number of relapses between paediatric and adult population groups. MRI brain was abnormal in 53% of patients. Among the 15 patients with MRI abnormalities at the onset, 53% had poor functional outcome at 1 year, while in 12 patients with normal initial MRI brain, only 8% had poor functional outcome at 1 year (p =0.01). Nearly 53% of patients with abnormal MRI at presentation had at least one clinical relapse within 2 years while in patients with normal MRI at presentation, 15% had a clinical relapse (p=0.037). EEG abnormalities were noticed in 71% of patients; among them, 40 and 15% had poor functional outcome at 1 and 2 years respectively. In comparison, those with normal first EEG at onset, 12% had poor functional outcome at 2 years (p=0.57). Conclusions: Both paediatric and adult patients presented with similar clinical features but the paediatric population had female preponderance. The functional outcome and number of relapse were comparable in both the paediatric and adult groups. Patients with parenchymal changes on MRI and abnormal EEG showed poorer response compared to those with normal MRI and/or EEG at the onset. Patients have lesser severity of symptoms at relapse than in the first episode. An early diagnosis and treatment are essential for better long-term functional outcome. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Neurological Sciences is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1007/s10072-021-05174-6 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 14 StartPage: 4683 Subjects: – SubjectFull: Child patients Type: general – SubjectFull: Prognosis Type: general – SubjectFull: Anti-NMDA receptor encephalitis Type: general – SubjectFull: Encephalitis Type: general – SubjectFull: Adults Type: general – SubjectFull: Disease relapse Type: general – SubjectFull: Gender Type: general Titles: – TitleFull: Clinical characteristics, treatment and long-term prognosis in patients with anti-NMDAR encephalitis. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Raja, Pritam – PersonEntity: Name: NameFull: Shamick, Biswas – PersonEntity: Name: NameFull: Nitish, L. K. – PersonEntity: Name: NameFull: Holla, Vikram Venkappayya – PersonEntity: Name: NameFull: Pal, P. K. – PersonEntity: Name: NameFull: Mahadevan, Anita – PersonEntity: Name: NameFull: Thomas, Priya Treesa – PersonEntity: Name: NameFull: Maya, Bhat – PersonEntity: Name: NameFull: Saini, J. – PersonEntity: Name: NameFull: Shantala, H. – PersonEntity: Name: NameFull: Netravathi, M. IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 11 Text: Nov2021 Type: published Y: 2021 Identifiers: – Type: issn-print Value: 15901874 Numbering: – Type: volume Value: 42 – Type: issue Value: 11 Titles: – TitleFull: Neurological Sciences Type: main |
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