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Observational Study
. 2023 May;65(5):691-700.
doi: 10.1111/dmcn.15429. Epub 2022 Oct 5.

Long-term outcome of paediatric anti-N-methyl-D-aspartate receptor encephalitis

Lorraine Flet-Berliac  1 , Nicolas Tchitchek  2 , Anne Lépine  3 , Anca Florea  1 , Hélène Maurey  1 , Pascale Chrétien  4   5 , Salima Hacein-Bey-Abina  4   5 , Frederic Villega  6   7 , Emmanuel Cheuret  8 , Véronique Rogemond  9 , Géraldine Picard  9 , Jérôme Honnorat  9 , Kumaran Deiva  1   10
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Free article
Observational Study

Long-term outcome of paediatric anti-N-methyl-D-aspartate receptor encephalitis

Lorraine Flet-Berliac et al. Dev Med Child Neurol. 2023 May.
Free article

Abstract

Aim: To study long-term clinical and cognitive outcomes of patients with anti-N-methyl-d-aspartate receptor encephalitis (NMDAR-E), an acute autoimmune neurological disease with severe acute presentations.

Method: In this French multicentre retrospective observational cohort study, patients no older than 18 years with a follow-up of at least 2 years were included. Data from clinical and cognitive assessments were collected.

Results: Eighty-one patients were included (57 females, 24 males; median age 10 years 7 months [range 1-18 years], median follow-up 40 months [range 25-53 months]). At last follow-up, 35 patients (45%) had cognitive impairment, 48 (70%) had academic difficulties, and 65 (92%) needed rehabilitation. Seventy-one patients (88%) had a modified Rankin Scale score of no more than 2. A higher number of symptoms at diagnosis was associated with cognitive impairment (p = 0.01), while an abnormal electroencephalogram at diagnosis increased the risk of academic difficulties (p = 0.03).

Interpretation: Although most children with NMDAR-E seemed to recover from motor disabilities, more than 45% had cognitive and academic difficulties. The initial severity of symptoms seems to have an impact on cognition and academic performances.

What this paper adds: Forty-five per cent of patients had cognitive impairment at ≥2 years diagnosis of anti-N-methyl-d-aspartate receptor encephalitis (NMDAR-E). Seventy per cent of patients had academic difficulties at ≥2 years diagnosis of NMDAR-E. Ninety-two per cent of patients needed rehabilitative care at ≥2 years diagnosis of NMDAR-E. A high number of symptoms at diagnosis were associated with cognitive impairment.

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References

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