Abstract | BACKGROUND: METHODS: We performed a retrospective analysis of a prospectively obtained cohort of ED patients from May 2011 to December 2017. We identified patients diagnosed with anti-NMDAR encephalitis in this cohort and extracted key patient characteristics and clinical data, including patient gender, age, presentation, modified Rank Score (m-RS), laboratory test results, significant treatments, and mortality. RESULTS: Eighty-seven patients with anti-NMDAR encephalitis were identified. 54 (62.1%) were female, 23 (26.4%) were < 18 years old, 14 (16.1%) had teratoma, and 45 (51.7%) had an m-RS ≥ 4. Fever, altered mental status, and seizures were the most common symptoms, with a > 50% incidence of each symptom in the cohort. The sensitivity of CSF oligoclonal band (OB) testing was 78.9%. 22 (25.3%) were admitted to the ICU, 20 (23.0%) patients were intubated, but only one patient died (1.1%). 47 (54.0%) were misdiagnosed prior to ED arrival. All patients underwent immunotherapy as first-line treatment for anti-NMDAR encephalitis. CONCLUSIONS: A majority of anti-NMDAR encephalitis patients presenting to the ED were female and were likely to be misdiagnosed prior to arrival. Patients with symptoms of fever, altered mental status, and seizures need a lumbar puncture, including CSF OB testing, for definitive diagnosis.
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Authors | Jin Xu, Na Zhao, Hongzhi Guan, Joseph Harold Walline, Huadong Zhu, Xuezhong Yu |
Journal | BMC neurology
(BMC Neurol)
Vol. 22
Issue 1
Pg. 224
(Jun 18 2022)
ISSN: 1471-2377 [Electronic] England |
PMID | 35717162
(Publication Type: Journal Article)
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Copyright | © 2022. The Author(s). |
Chemical References |
- Receptors, N-Methyl-D-Aspartate
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Topics |
- Adolescent
- Anti-N-Methyl-D-Aspartate Receptor Encephalitis
(complications, diagnosis, therapy)
- Emergency Service, Hospital
- Female
- Humans
- Male
- Receptors, N-Methyl-D-Aspartate
- Retrospective Studies
- Seizures
(complications)
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