title: Clinical characteristics and outcomes between children and adults with anti-N-Methyl-D-Aspartate receptor encephalitis.
abstract: Anti-N-Methyl-D-Aspartate receptor (NMDAR) encephalitis is an acute neurological disorder affecting children and adults. We aimed to compare the clinical characteristics, treatments, and outcomes between children and adults with anti-NMDAR encephalitis and to assess the probable risk factors. In this observational study, patients who tested positive for anti-NMDAR antibody in the cerebrospinal fluid were enrolled. The patients were divided into children and adults group on the basis of age (whether <16 or not). Clinical outcomes were assessed at onset, 1, 3, 6, 9, and 12 months after the patients received treatment and were scored based on whether they required hospitalization and intensive care. A total of 15 children and 14 adults were examined. The adults more likely manifested status epilepticus, central hypoventilation, and pneumonia but less likely exhibited movement disorder than the children did. All of the patients were subjected to corticosteroid treatment, 11 children and 9 adults were treated with intravenous immunoglobulin, and only the adults received plasma exchange or cyclophosphamide. The children recovered faster than the adults, especially in the first 6 months. Risk factors included age, status epilepticus, changes in consciousness, central hypoventilation, and pneumonia. Adults exhibit worse outcomes than children mostly because of status epilepticus.
authors.affiliation: Department of Neurology, First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Huang
authors.affiliation: Department of Neurology, First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China. Nwuyuan90@163.com.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Wu
authors.affiliation: Department of Neurology, First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China.
authors.forename: Rongfa
authors.initials: R
authors.lastname: Qin
authors.affiliation: Department of Neurology, First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China.
authors.forename: Xing
authors.initials: X
authors.lastname: Wei
authors.affiliation: Department of Neurology, First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China.
authors.forename: Meigang
authors.initials: M
authors.lastname: Ma
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D000367:Age Factors; D000375:Aging; D060426:Anti-N-Methyl-D-Aspartate Receptor Encephalitis / Q000134:cerebrospinal fluid / Q000000981:diagnostic imaging / Q000628:therapy*; D000906:Antibodies / Q000134:cerebrospinal fluid; D058256:Brain Waves / Q000187:drug effects / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D005260:Female; D005500:Follow-Up Studies; D057809:HEK293 Cells; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007155:Immunologic Factors / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016194:Receptors, N-Methyl-D-Aspartate / Q000235:genetics / Q000276:immunology / Q000378:metabolism; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D014162:Transfection; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D000906:Antibodies; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors; C409466:NR1 NMDA receptor; D016194:Receptors, N-Methyl-D-Aspartate
keywords: Adults; Anti-NMDAR encephalitis; Children; Prognosis; Status epilepticus