Table 2.
CEP NMDAR cases vs. confirmed viral cases
| NMDAR (n = 10) | Confirmed HSV-1 cases (n = 52) | Confirmed enterovirus cases (n = 85) | Confirmed rabies cases (n = 6) | |
|---|---|---|---|---|
| Demographics | ||||
| Age, median, years | 18.5 (range 11–31) | 46.0 (range 0–89) | 14.0 (range 0–75) | 38.5 (range 11–72) |
| Gender | ||||
| Male | 4 (40%) | 26 (50%) | 52 (61%) | 6 (100%) |
| Female | 6 (60%) | 26 (50%) | 33 (39%) | 0 |
| Ethnicity | ||||
| White, Hispanic | 2 (20%) | 8 (15%) | 26 (31%) | 1 (17%) |
| White, non-Hispanic | 0 | 27 (52%) | 30 (35%) | 1 (17%) |
| Black | 3 (30%) | 2 (4%) | 7 (8%) | 0 |
| Asian/Pacific Islander | 5 (50%) | 3 (6%) | 10 (12%) | 2 (33%) |
| Other/unknown | 0 | 12 (23%) | 11 (13%) | 2 (33%) |
| Clinical findings | ||||
| General symptoms | ||||
| Fever | 7 (70%) | 46 (88%) | 63 (74%) | 4 (67%) |
| GI | 5 (50%) | 19 (36%) | 35 (41%) | 5 (83%) |
| URI | 1 (10%) | 11 (21%) | 24 (28%) | 4 (67%) |
| Rash | 0 | 3 (6%) | 15 (18%) | 0 |
| Intubation | 6 (60%) | 8 (15%) | 4 (5%) | 5 (83%) |
| ICU admission | 8 (80%) | 30 (58%) | 28 (33%) | 4 (67%) |
| Seizures | 8 (80%) | 30 (58%) | 24 (28%) | 2 (33%) |
| Coma | 3 (30%) | 8 (15%) | 5 (6%) | 5 (83%) |
| Died | 1 (10%) | 9 (17%) | 5 (6%) | 6 (100%) |
| Neurologic symptoms | ||||
| Altered consciousness | 5 (50%) | 32 (62%) | 31 (36%) | 4 (67%) |
| Ataxia | 6 (60%) | 7 (13%) | 23 (27%) | 0 |
| Focal neurologic signs | 6 (60%) | 17 (33%) | 24 (28%) | 2 (33%) |
| Stiff neck | 3 (30%) | 16 (31%) | 27 (32%) | 0 |
| Cranial nerve abnormality | 3 (30%) | 0 | 3 (4%) | 0 |
| Psychiatric symptoms | ||||
| Hallucinations | 6/9 (67%) | 8 (15%) | 9 (11%) | 1 (17%) |
| Psychosis | 6/9 (67%) | 1 (2%) | 2 (2%) | 0 |
| Personality change | 10 (100%) | 15 (29%) | 7 (8%) | 2 (33%) |
| Irritability | 7 (70%) | 11 (21%) | 29 (34%) | 1 (17%) |
| Laboratory dataa | ||||
| CSF | ||||
| WBC, median (range), per mm3 | 22 (range 3–170) | 90 (range 0–110) | 55.5 (range 0–1,332) | 3.5 (range 0–10) |
| Protein, mg/dL | 28.5 (range 21–220) | 65 (range 6–297) | 54 (range 16–881) | 35 (range 32–172) |
| Glucose, mg/dL | 62 (range 55–72) | 68 (range 39–112) | 66 (range 27–159) | 65 (range 60–110) |
| Neuroimaging abnormalitya | ||||
| MRI | ||||
| Temporal lobe | 0 | 36 (69%) | 4 (5%) | 0 |
| Hydrocephalus | 0 | 1 (2%) | 0 | 0 |
| White matter involvement | 1 (10%) | 4 (8%) | 4 (5%) | 0 |
| Cerebral edema | 0 | 1 (2%) | 0 | 0 |
| CT | ||||
| Temporal lobe | 0 | 14 (27%) | 0 | 0 |
| Hydrocephalus | 0 | 1 (2%) | 3 (4%) | 0 |
| White matter involvement | 0 | 1 (2%) | 2 (2%) | 0 |
| Cerebral edema | 0 | 0 | 0 | 0 |
| EEG | ||||
| Slowing | 8 (80%) | 9 (17%) | 7 (8%) | 2 (33%) |
| Epileptiform activity | 1 (10%) | 7 (13%) | 2 (2%) | 0 |
| PLEDs | 0 | 4 (8%) | 1 (1%) | 0 |
CSF = cerebrospinal fluid; WBC = white blood cell; MRI =magnetic resonance imaging; CT = computed tomography; EEG =electroencephalogram; PLEDs = periodic lateralized epileptiform discharges; ICU = intensive care unit
Denominators used in the calculations may vary, depending on the available data
aData are from initial neuroimaging studies or initial lumbar puncture