title: Epileptic phenotypes, electroclinical features and clinical characteristics in 17 children with anti-NMDAR encephalitis.
abstract: BACKGROUND
  Anti-N-methyl d-aspartate receptor (NMDAR) encephalitis is a rare disorder characterized by seizures, neuropsychiatric symptoms, dyskinesia and autonomic instability.
  
  
  OBJECTIVE
  Aim of the present study was to evaluate the seizure phenotypes and electroencephalogram (EEG) features in children with anti-NMDAR encephalitis.
  
  
  METHODS
  Seizure types, electroclinical features and clinical characteristics of 17 children with anti-NMDAR encephalitis were analysed in a retrospective case series from nine centres in Europe.
  
  
  RESULTS
  Nearly half (8/17) of the children presented with psychiatric symptoms, whereas in 4/17 patients seizures were the first symptom and in 5/17 both symptoms occurred at the same time. During the following course seizures were reported in 16/17 children. The first EEG detected generalized slowing in 11/17 patients, focal slowing in 3/17 and normal background activity in only 3/17 children. The extreme delta brush (EDB) pattern was detected in 9/17 (53%) patients.
  
  
  CONCLUSIONS
  In addition to psychiatric symptoms, children with anti-NMDAR encephalitis often show generalized slowing in EEG with or without seizures at initial presentation. EDB is present in half of all children and is potentially a helpful tool for early detection of this immune-mediated disease.
authors.affiliation: Clinical Department of Pediatrics I, Neuropediatrics, Medical University of Innsbruck, Innsbruck, Austria. Electronic address: edda.haberlandt@tirol-kliniken.at.
authors.forename: E
authors.initials: E
authors.lastname: Haberlandt
authors.affiliation: Department of Pediatric Neurology and Developmental Medicine and Social Pediatrics, Dr. von Haunersches Children's Hospital, University of Munich, Munich, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Ensslen
authors.affiliation: Department of Pediatrics, Medical University of Graz, Graz, Austria.
authors.forename: U
authors.initials: U
authors.lastname: Gruber-Sedlmayr
authors.affiliation: Department of Neuropaediatrics and Neurophysiology, University Children's Hospital, Zuerich, Switzerland.
authors.forename: B
authors.initials: B
authors.lastname: Plecko
authors.affiliation: Department of Pediatrics, Medical University of Graz, Graz, Austria.
authors.forename: M
authors.initials: M
authors.lastname: Brunner-Krainz
authors.affiliation: Department of Pediatrics, Klinikum Augsburg, Augsburg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Schimmel
authors.affiliation: Department of Pediatric Neurology, University Children's Hospital Heidelberg, Heidelberg, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Schubert-Bast
authors.affiliation: Department of Pediatrics, Neurology, Stiftungskrankenhäuser Frankfurt am Main, Clementine Kinderhospital, Frankfurt am Main, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Neirich
authors.affiliation: Sozialpädiatrisches Zentrum Frankfurt Mitte, Frankfurt am Main, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Philippi
authors.affiliation: Department of General Pediatrics, Neuropediatrics, University Children's Hospital Münster, Münster, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Kurleman
authors.affiliation: Assistance publique hôpitaux de Paris, Hôpitaux universitaires Paris-Sud, Université Paris-Sud, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Tardieu
authors.affiliation: Department of Neuropaediatrics and Neurophysiology, University Children's Hospital, Zuerich, Switzerland.
authors.forename: G
authors.initials: G
authors.lastname: Wohlrab
authors.affiliation: Department of Pediatric Neurology and Developmental Medicine and Social Pediatrics, Dr. von Haunersches Children's Hospital, University of Munich, Munich, Germany.
authors.forename: I
authors.initials: I
authors.lastname: Borggraefe
authors.affiliation: Department of Pediatric Neurology, Children's Hospital Datteln, University Witten/Herdecke, Witten, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Rostásy
mesh_terms: D000293:Adolescent; D060426:Anti-N-Methyl-D-Aspartate Receptor Encephalitis / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D003700:Delta Rhythm / Q000502:physiology*; D042241:Early Diagnosis; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008297:Male; D010641:Phenotype; D012189:Retrospective Studies; D012640:Seizures / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology*
keywords: Anti-NMDAR encephalitis; Children; Delta brush; Epilepsy; Extreme; Focal seizures; Generalized seizures