Clinical analysis of patients with anti-N-methyl-D-aspartate receptor encephalitis: a report of 3 cases / 中华神经医学杂志

ABSTRACT

Objective To explore the clinical features,laboratory test results,diagnosis,treatment and prognosis of patients with anti-N-methyl-D-aspartic acid receptor (NMDAR) encephalitis.Methods A retrospectives analysis of clinical characteristics,laboratory test,treatment and prognosis of 3 patients with NMDRA encephalitis,admitted to our hospital from February 2012 to November 2014,was performed in our study.Results The most predominant symptoms of 3 patients with anti-NMDAR encephalitis included fever,psychiatric behavioral disturbances,seizures,orofacial dyskinesias and movement disorders and autonomic dysfunction.One patient had immature ovarian teratoma and one had mature mediastinal teratoma.Anti-NMDAR antibody was positive in serum and cerebrospinal fluid of two patients with teratoma,and anti-NMDAR antibody was positive in cerebrospinal fluid and negative in serum of one patient without tumour;all three patients showed abnormal electroencephalography,and 2 had increased signal on MR imaging T2 sequences or fluid-attenuated inversion.Patients were responsive to early immunotherapy and tumour resection.Conclusion The patient with NMDAR encephalitis presented with characteristic clinical manifestations;detection of anti-NMDAR antibody in serum and cerebrospinal fluid may be important for early diagnosis;early immunotherapy and tumour resection are effective for patients with NMDAR encephalitis.