Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis: A series of ten cases from a university hospital in Malaysia
- Author:
Suhailah Abdullah
;
Shen-Yang Lim
;
Khean Jin Goh
;
Lucy CS Lum
;
Chong Tin Tan
- Publication Type:Journal Article
- From:Neurology Asia
2011;16(3):241-246
- CountryMalaysia
- Language:English
-
Abstract:
Objective: To report on the incidence, and the clinical and laboratory features of patients seen at the
University of Malaya Medical Centre with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis.
Methods: The charts of all patients admitted to the adult neurology ward with encephalitis over an 18-
month period from January 2010 to June 2011 were reviewed. Diagnosis of anti-NMDAR encephalitis
was based on the presence of encephalitis plus antibody against the NMDAR. Two other paediatric
patients with anti-NMDAR encephalitis seen over the same period were also included in this report.
Results: There was a total of 10 patients with anti-NMDAR encephalitis seen over the study period.
The mean age was 18.1 years (range 9-29 years). Eight patients were female, two male. Five were
Malay and fi ve were Chinese. All patients had prominent psychiatric symptoms, followed by epileptic
seizures. Nine patients had a movement disorder, orofacial dyskinesia being the commonest, and all
had autonomic involvement. None had an underlying tumour. Treatments consisted of corticosteroid,
plasma exchange and intravenous immunoglobulin (IVIG). The clinical outcome was variable, with
full recovery (2), substantial recovery (3), partial recovery (4), and mortality (1) seen. Remarkably,
the eight adult cases of anti-NMDAR encephalitis accounted for 50% of the 16 cases of encephalitis
seen during the study period.
Conclusion: Anti-NMDAR encephalitis may be a relatively common cause of adult encephalitis among
certain Asian groups. None of our cases was paraneoplastic in origin.
- Full text:P020150818560059113346.pdf
