title: Longitudinal electroencephalographic (EEG) findings in pediatric anti-N-methyl-D-aspartate (anti-NMDA) receptor encephalitis: the Padua experience.
abstract: To contribute to characterize electroencephalographic (EEG) activity in pediatric anti-N-methyl-d-aspartate (anti-NMDA) receptor encephalitis, we reviewed electroclinical data of 5 children with anti-NMDA receptor encephalitis diagnosed in our department. We identified 4 longitudinal electroencephalographic phases: in the early phase, background activity was normal, with intermixed nonreactive slow waves; in the florid phase, background activity deteriorated with appearance of sequences of peculiar rhythmic theta and/or delta activity unrelated to clinical changes, unresponsive to stimuli and antiepileptic medications; in the recovery phase, these sequences decreased and reactive posterior rhythm re-emerged; electroencephalogram normalized 2 to 5 months after onset. In conclusion, in the presence of evocative clinical history, recognizing a characteristic longitudinal electroencephalographic activity could provide ancillary aspects addressing the diagnosis and the overall management of children with anti-N-methyl-d-aspartate receptor encephalitis; in particular, knowing that peculiar and recurrent paroxysmal nonepileptic rhythmic theta-delta patterns can occur in these patients could help distinguish paroxysmal epileptic and nonepileptic electroencephalographic activity.
authors.affiliation: Pediatric Neurology Unit, Department of Pediatrics, University of Padua, Italy.
authors.forename: Margherita
authors.initials: M
authors.lastname: Nosadini
authors.affiliation: Pediatric Neurophysiology Unit, Department of Pediatrics, University of Padua, Italy.
authors.forename: Clementina
authors.initials: C
authors.lastname: Boniver
authors.affiliation: Department of Neurology, Ca' Foncello Hospital, Treviso, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Zuliani
authors.affiliation: Pediatric Neurophysiology Unit, Department of Pediatrics, University of Padua, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: de Palma
authors.affiliation: Pediatric Neurology Unit, Department of Pediatrics, University of Padua, Italy Pediatric Neurophysiology Unit, Department of Pediatrics, University of Padua, Italy Lifespan Cognitive Neuroscience Laboratory, Department of General Psychology, University of Padua, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Cainelli
authors.affiliation: Pediatric Neurology Unit, Department of Pediatrics, University of Padua, Italy.
authors.forename: Pier Antonio
authors.initials: PA
authors.lastname: Battistella
authors.affiliation: Pediatric Neurology Unit, Department of Pediatrics, University of Padua, Italy.
authors.forename: Irene
authors.initials: I
authors.lastname: Toldo
authors.affiliation: Pediatric Neurology Unit, Department of Pediatrics, University of Padua, Italy.
authors.forename: Agnese
authors.initials: A
authors.lastname: Suppiej
authors.affiliation: Pediatric Neurology Unit, Department of Pediatrics, University of Padua, Italy stefano.sartori@unipd.it.
authors.forename: Stefano
authors.initials: S
authors.lastname: Sartori
mesh_terms: D060426:Anti-N-Methyl-D-Aspartate Receptor Encephalitis / Q000503:physiopathology*; D058256:Brain Waves / Q000502:physiology*; D002648:Child; D018450:Disease Progression; D004569:Electroencephalography; D005260:Female; D006801:Humans; D007558:Italy; D008137:Longitudinal Studies; D008297:Male
keywords: EEG; anti-NMDAR encephalitis; children; rhythmic pattern; seizure