RESUMO
We report on an 8-year-old boy with non-paraneoplastic anti-NMDA receptor (NMDAR) encephalitis, who presented with psychotic symptoms and involuntary movement following an intractable seizure. His serum and CSF tested positive for anti-NMDAR antibodies. He received an initial immunotherapy consisting of methylprednisolone pulse therapy (mPSL) and intravenous immunoglobulin therapy (IVIg), without any clinical improvement. He had three cycles of monthly cyclophosphamide pulse therapy (500 mg/m2), and his clinical condition started to improve gradually two weeks after the first cycle, without any side effects. Six months after onset, he tested normal upon standard neurological examination. Cyclophosphamide therapy should be considered for children with anti-NMDAR encephalitis, as well as mPSL and IVIg.
Assuntos
Encefalite Antirreceptor de N-Metil-D-Aspartato/tratamento farmacológico , Ciclofosfamida/uso terapêutico , Imunoglobulinas Intravenosas/uso terapêutico , Receptores de N-Metil-D-Aspartato/imunologia , Encefalite Antirreceptor de N-Metil-D-Aspartato/diagnóstico , Criança , Humanos , Masculino , Resultado do TratamentoRESUMO
Wolff-Parkinson-White (WPW) syndrome can be the cause of syncope or sudden cardiac death, which results from ventricular fibrillation (VF) degenerated from rapid anterograde conduction of atrial fibrillation (AF) to the ventricles through the accessory pathway. We present a case of WPW syndrome in which recording the actual moment of onset of the degeneration of pre-excited AF into VF. This was fortuitous and also lucky for this patient.