The spectrum of movement disorders in children with anti-NMDA receptor encephalitis.

ABSTRACT

BACKGROUND: Movement disorders are frequent but difficult to characterize in patients with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. METHODS: The phenomenology of movement disorders was characterized after a detailed examination of children with anti-NMDAR-encephalitis. RESULTS: We studied 9 children (5 females), ages 3-14 years, with confirmed anti-NMDAR-encephalitis. All patients presented with at least 1 movement disorder, including chorea (n=4), stereotypic movements (n=4), ataxia (n=3), limb dystonia (n=2), limb myorhythmia (n=2), oromandibular dystonia (n=2), facial myorhythmia, blepharospasm, opisthotonus, athetosis, and tremor (n=1, each). More than a single movement disorder was observed in 6 of these patients. Resolution of the abnormal movements was observed in all patients with immunotherapy; 1 patient improved with tetrabenazine. CONCLUSIONS: A wide variety of movement disorders, often in combination, can be observed in children with anti-NMDAR encephalitis. Patients commonly present with more than a single movement disorder.