title: Does early treatment improve outcomes in N-methyl-D-aspartate receptor encephalitis?
abstract: N-methyl-d-aspartate (NMDA) receptor encephalitis is a treatable cause of autoimmune encephalitis in both children and adults. It is still unclear if the natural history of the condition in children is altered by early treatment with immunosuppressive therapy. We looked at the outcomes of five children (two males, three females; mean age 6y 9mo, range 4-8y) who were treated empirically for autoimmune encephalitis within a brief period of presentation. Features that led clinicians to suspect autoimmune encephalitis included prominent neuropsychiatric features, movement disorder, seizures, and dysautonomic features. Immunosuppressive therapy was carried out in all cases. In this series of children, in whom the median time from symptom onset to treatment was 5 days and median length of time for follow-up was 24 months, four out of the five (80%) recovered to their baseline. Early initiation of immunosuppressive therapy may result in improved clinical outcomes.
authors.affiliation: Children's University Hospital, Dublin, Ireland; Our Lady's Children's Hospital, Dublin, Ireland.
authors.forename: Susan
authors.initials: S
authors.lastname: Byrne
authors.forename: Blathanid
authors.initials: B
authors.lastname: McCoy
authors.forename: Bryan
authors.initials: B
authors.lastname: Lynch
authors.forename: David
authors.initials: D
authors.lastname: Webb
authors.forename: Mary D
authors.initials: MD
authors.lastname: King
mesh_terms: D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000494:pharmacology; D060426:Anti-N-Methyl-D-Aspartate Receptor Encephalitis / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage / Q000494:pharmacology; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000494:pharmacology; D007275:Injections, Intravenous; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000494:pharmacology; D011239:Prednisolone / Q000008:administration & dosage / Q000494:pharmacology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D016756:Immunoglobulins, Intravenous; D007166:Immunosuppressive Agents; D011239:Prednisolone; D008775:Methylprednisolone