{"id":1758,"date":"2022-09-18T15:27:00","date_gmt":"2022-09-18T12:27:00","guid":{"rendered":"https:\/\/pediatria-spisanie.eu\/2022\/09\/18\/avtoimenen-antinmdareceptoren-encefalit\/"},"modified":"2025-05-21T16:19:23","modified_gmt":"2025-05-21T13:19:23","slug":"avtoimenen-antinmdareceptoren-encefalit","status":"publish","type":"post","link":"https:\/\/pediatria-spisanie.eu\/en\/2022\/09\/18\/avtoimenen-antinmdareceptoren-encefalit\/","title":{"rendered":"Autoimmune anti-NMDA-receptor Encephalitis &#8211; the Difficult Diagnostic Pathway"},"content":{"rendered":"\n\n\t\t<div class=\"icon-box featured-box icon-box-left text-left is-small\"  >\n\t\t\t\t\t<div class=\"icon-box-img\" style=\"width: 20px\">\n\t\t\t\t<div class=\"icon\">\n\t\t\t\t\t<div class=\"icon-inner\" >\n\t\t\t\t\t\t<img decoding=\"async\" width=\"48\" height=\"48\" src=\"https:\/\/pediatria-spisanie.eu\/wp-content\/uploads\/2024\/12\/icons8-user-48.png\" class=\"attachment-medium size-medium\" alt=\"\" \/>\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t\t<div class=\"icon-box-text last-reset\">\n\t\t\t\t\t\t\t\t\t\n<h3>L. Dimitrova, T. Paneva, L. Bozadzhieva, P. Pavlov, G. Peev, P. Bozhilova, Iv. Litvinenko, I. Ivanov, D. Iliev <\/h3>\n<p> <\/br>\n<\/p>\n\t\t<\/div>\n\t<\/div>\n\t\n\t\n<div class=\"is-divider divider clearfix\" ><\/div>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Abstract<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Anti-N-methyl-D-aspartate-receptor antibody encephalitis is a disorder, characterized by psychotic production, loss of consciousness, seizures and autonomic dysfunction. The following case presents an adolescent with headache, weakness, hallucinations, dynamic consciousness, psychomotor agitation, generalized tonic-clonic seizures and autonomic imbalance. Magnetic resonance imaging of central nervous system, electroencephalogram and spinal fluid investigations (biochemistry, microbiology and electrophoresis) don\u2019t show pathologic changes at first. Diagnosis is based on finding the pathognomonic antibodies in blood and cerebrospinal fluid after secondary investigation. Therapy with intravenous corticosteroids and immunoglobulin is started and followed by significant clinical improvement.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Keywords:<\/strong> N-methyl-D-aspartate, encephalitis, hallucinations, generalized tonic-clonic seizures, cerebrospinal fluid, antibodies<\/p>\n\n\n<div class=\"is-divider divider clearfix\" ><\/div>\n\n\n\t\t<div class=\"wp-block-woocommerce-memberships-member-content\">\n\t\t\t\t\t<div class=\"woocommerce\">\n\t\t\t<div class=\"woocommerce-info wc-memberships-restriction-message wc-memberships-message wc-memberships-content-restricted-message\">\n\t\t\t\tTo access this content, you must purchase <span class=\"wc-memberships-products-grant-access\"><a href=\"https:\/\/pediatria-spisanie.eu\/en\/produkt\/godishen-abonament\/\">\u0413\u043e\u0434\u0438\u0448\u0435\u043d \u0430\u0431\u043e\u043d\u0430\u043c\u0435\u043d\u0442<\/a><\/span>.\t\t    <\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\n\n\n<h2 class=\"wp-block-heading\"><strong>Bibliography<\/strong><\/h2>\n\n\n\n<ol class=\"wp-block-list\">\n<li><strong>Leypoldt F., Wandinger KP., Bien C. G.<\/strong><strong>&nbsp; <\/strong><strong>et al. &nbsp;<\/strong>Autoimmune Encephalitis. European Neurological Review. 2012<strong>;<\/strong>8(1):<em> 31.<\/em><\/li>\n\n\n\n<li><strong>Chiang S, Garg T, Hu<\/strong><strong> <\/strong><strong>A et al.<\/strong> Pearls &amp; Oy-sters: Relapse of anti-NMDA receptor encephalitis after prior first- and second-line immunotherapy Neurology\u00ae 2018; 90: 936-939<\/li>\n\n\n\n<li><strong>Kelley, B. P., Patel, S. C., Marin, et al. <\/strong>&nbsp;Autoimmune Encephalitis: Pathophysiology and Imaging Review of an Overlooked Diagnosis. American Journal of Neuroradiology. 2017;38(6):1070\u20131078.<\/li>\n\n\n\n<li><strong>\u0412. \u0411\u043e\u0436\u0438\u043d\u043e\u0432\u0430, \u0414. \u0414\u0435\u043d\u0435\u0432\u0430, \u0410. \u0410\u0441\u0435\u043d\u043e\u0432\u0430 \u0438 \u0441\u044a\u0442\u0440<\/strong>., \u0410\u0432\u0442\u043e\u0438\u043c\u0443\u043d\u043d\u0438 \u0435\u043d\u0446\u0435\u0444\u0430\u043b\u0438\u0442\u0438 \u0432 \u0434\u0435\u0442\u0441\u043a\u0430\u0442\u0430 \u0432\u044a\u0437\u0440\u0430\u0441\u0442 &#8211; \u043a\u0440\u0438\u0442\u0435\u0440\u0438\u0438 \u0438 \u0430\u043b\u0433\u043e\u0440\u0438\u0442\u044a\u043c \u0437\u0430 \u0434\u0438\u0430\u0433\u043d\u043e\u0441\u0442\u0438\u043a\u0430 \u0438 \u043b\u0435\u0447\u0435\u043d\u0438\u0435, \u0411\u044a\u043b\u0433\u0430\u0440\u0441\u043a\u0430 \u043d\u0435\u0432\u0440\u043e\u043b\u043e\u0433\u0438\u044f. 2017; vol. 18:194-200<\/li>\n\n\n\n<li><strong>\u0418. \u041c\u0438\u043b\u0430\u043d\u043e\u0432, \u0412. \u0411\u043e\u0436\u0438\u043d\u043e\u0432\u0430, \u0418.<\/strong> <strong>\u0418\u0432\u0430\u043d\u043e\u0432.&nbsp; <\/strong>\u041d\u0430\u0446\u0438\u043e\u043d\u0430\u043b\u0435\u043d \u043a\u043e\u043d\u0441\u0435\u043d\u0441\u0443\u0441 \u0437\u0430 \u0434\u0438\u0430\u0433\u043d\u043e\u0441\u0442\u0438\u043a\u0430 \u0438 \u043b\u0435\u0447\u0435\u043d\u0438\u0435 \u043d\u0430 \u043e\u0441\u0442\u0440\u0438 \u0438 \u0430\u0432\u0442\u043e\u0438\u043c\u0443\u043d\u043d\u0438 \u0435\u043d\u0446\u0435\u0444\u0430\u043b\u0438\u0442\u0438 \u0438 \u0432\u0438\u0440\u0443\u0441 \u0438\u043d\u0434\u0443\u0446\u0438\u0440\u0430\u043d\u0438 \u0435\u043d\u0446\u0435\u0444\u0430\u043b\u043e\u043f\u0430\u0442\u0438\u0438. \u0411\u044a\u043b\u0433\u0430\u0440\u0441\u043a\u0430 \u043d\u0435\u0432\u0440\u043e\u043b\u043e\u0433\u0438\u044f 2019; 20, \u0414\u043e\u043f\u044a\u043b\u043d\u0435\u043d\u0438\u0435 3:1-23.<\/li>\n\n\n\n<li><strong>Stingl <\/strong><strong>C<\/strong><strong>, <\/strong><strong>Caedinale K, Van Mater H. <\/strong>An update on the treatment of Pediatric autoimmune encephalitis. Current Treat Options in Rheum. 2018; 4:14-28<\/li>\n\n\n\n<li><strong>Zeng W, Cao L<\/strong><strong>, <\/strong><a href=\"https:\/\/link.springer.com\/article\/10.1007\/s10072-020-04482-7#auth-Jinou-Zheng\"><strong>Zhe<\/strong><\/a><strong>ng J<\/strong><strong> et al. <\/strong>Clinical characteristics and long-term prognosis of relapsing anti-N-methyl-D-aspartate receptor encephalitis: a retrospective, multicenter, self-controlled study. Neurological science.&nbsp; 2021; 42:199\u2013207<\/li>\n\n\n\n<li><strong>Cellucci T, Van Mater H, Graus <\/strong><strong>C <\/strong>et al. Clinical approach to the diagnosis of autoimmune encephalitis in the pediatric patient. Neurology &#8211; Neuroimmunology Neuroinflammation 2020;7(2), e663<\/li>\n\n\n\n<li><strong>E. Lancaster.<\/strong>The Diagnosis and Treatment of Autoimmune Encephalitis. Journal of Clinical Neurology 2016;12(1):1<\/li>\n\n\n\n<li><strong>Pruss H, Dalmau J, Harms L<\/strong> et al. Retrospective analysis of NMDA receptor antibodies in encephalitis of unknown origin. Neurology. 2010;75(19):1735\u20131739<em>.<\/em><\/li>\n<\/ol>\n\n\n<div class=\"is-divider divider clearfix\" ><\/div>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Address for correspondence:<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">SBALDB \u201cProf. D-r Ivan Mitev\u201d &#8211; Sofia<br>11, \u201cAcad. I. Geshov\u201d, Blvd.<br>1606, Sofia, Bulgaria<br>e-mail: <a href=\"mailto:dimitrova@gmail.com\">dimitrova@gmail.com<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>L. Dimitrova, T. Paneva, L. Bozadzhieva, P. Pavlov, G. Peev, P. Bozhilova, Iv. Litvinenko, I. Ivanov, D. Iliev<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_pediatria_doi":"","footnotes":""},"categories":[1301,1337],"tags":[2199,2200,2201,2202,2203,2204,2205],"class_list":["post-1758","post","type-post","status-publish","format-standard","hentry","category-articles","category-issue-3-2022","tag-avtoimunen-anti-nmda-reczeptoren-enczefalit-trudniyat-pat-kam-diagnozata-en","tag-g-peev-1-en","tag-l-bozadzhieva1-en","tag-l-dimitrova1-en","tag-p-bozhilova-1-en","tag-p-pavlov-1-en","tag-t-paneva1-en"],"_links":{"self":[{"href":"https:\/\/pediatria-spisanie.eu\/en\/wp-json\/wp\/v2\/posts\/1758","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pediatria-spisanie.eu\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/pediatria-spisanie.eu\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/pediatria-spisanie.eu\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/pediatria-spisanie.eu\/en\/wp-json\/wp\/v2\/comments?post=1758"}],"version-history":[{"count":1,"href":"https:\/\/pediatria-spisanie.eu\/en\/wp-json\/wp\/v2\/posts\/1758\/revisions"}],"predecessor-version":[{"id":1760,"href":"https:\/\/pediatria-spisanie.eu\/en\/wp-json\/wp\/v2\/posts\/1758\/revisions\/1760"}],"wp:attachment":[{"href":"https:\/\/pediatria-spisanie.eu\/en\/wp-json\/wp\/v2\/media?parent=1758"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/pediatria-spisanie.eu\/en\/wp-json\/wp\/v2\/categories?post=1758"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/pediatria-spisanie.eu\/en\/wp-json\/wp\/v2\/tags?post=1758"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}