Table 1.
Demographic features, details of clinical presentation and course, and results of diagnostic testing for 11 anti-NMDAR encephalitis patients evaluated at our center.
| Case | Age, M/F | Symptoms/Signs | NMDAR IgG antibody test results | Additional diagnostic testing | Treatment | |||
|---|---|---|---|---|---|---|---|---|
| In-House | Reference | |||||||
| CSF | Serum | CSF | Serum | |||||
| 1 | 20F | 1. A/P, Sz 2. Dk, Da |
+ (Day 57) | NA | + (Day 57) | NA | EEG: AC MRI Brain: ANS Tumor: none |
Oral steroids, IVMP, IVIg, PLEX, rituximab |
| 2 | 23F | 1. A/P 2. SD 3. LOC, Dk, Da |
+ (Day 32) | − (Day 30) | + (Day 32) | NA | EEG: AC MRI Brain: Nm Tumor: Mature ovarian teratoma |
IVMP, IVIg, PLEX |
| 3 | 35F | 1. LOC, SD 2. A/P 3. Da |
+ (Day 31) | NA | + (Day 31) | NA | EEG: ANS MRI Brain: Nm Tumor: none |
IVMP, IVIg |
| 4 | 31M | 1. LOC, Sz 2. A/P 3. Da |
NA | − (Day 32) | + (Day 24) | − (Day 32) | EEG: ANS MRI Brain: Nm Tumor: none |
IVMP, PLEX, IVIg |
| 5 | 18F | 1. A/P 2. LOC, Dk, Da |
NA | NA | + (Day 23) | − (Day 23) | EEG: ANS MRI Brain: Nm Tumor: none |
IVMP, PLEX, rituximab |
| 6 | 15M | 1. SD 2. LOC 3. A/P, Dk |
NA | NA | + (Day 28) | NA | EEG: Nm MRI Brain: Nm Tumor: none |
IVMP |
| 7 | 20M | 1. Dk 2. SD, A/P, Sz |
NA | − (Day 10) | + (Day 11) | − (Day 10) | EEG: ANS MRI Brain: ANS Tumor: none |
IVMP, IVIg |
| 8 | 32F | 1. A/P 2. Dk 3. LOC 4. SD, Sz, Da |
+ (Day 32) | − (Day 31) | NA | NA | EEG: ANS MRI Brain: Nm Tumor: none |
IVMP, IVIg, PLEX, rituximab |
| 9 | 23M | 1. A/P, LOC 2. Sz |
NA | NA | + (Day 17) | NA | EEG: ANS MRI Brain: AC Tumor: none |
IVMP, IVIg, rituximab |
| 10 | 52F | 1. SD 2. LOC 3. A/P 4. Dk 5. Sz |
+ (Day 219) | − (Day 218) | + (Day 219) | NA | EEG: ANS MRI Brain: ANS Tumor: none |
Oral steroid, IVMP, IVIg |
| 11 | 28F | 1. Sz, Da 2. SD, A/P 3. Dk, LOC |
+ (Day 13) | − (Day 11) | NA | NA | EEG: AC MRI: Nm Tumor: none |
IVMP, PLEX, rituximab |
Symptoms are ordered by onset. Timing of CSF and serum testing is presented relative to the day of symptom onset. MRI and EEG findings were either normal (Nm: indicating no pathological abnormality), abnormal-nonspecific (ANS: indicating abnormalities that are not specific for anti-NMDAR encephalitis, including non-specific FLAIR signal changes on MRI, and slowing on EEG) or abnormal-consistent (AC: indicating abnormalities that are consistent with anti-NMDAR encephalitis, such as mesial temporal lobe signal changes with or without extension into adjacent limbic structures on MRI, and delta-brush on EEG). No adverse events were attributed to blood draw or lumbar puncture. +: Positive result; -: Negative result; A/P: Agitation / Psychosis; CSF: Cerebrospinal fluid; Da: dysautonomia; Dk: Dyskinesia; EEG: Electroencephalogram; FLAIR: T2-fluid-attenuated inversion recovery; LOC: Altered level of consciousness; MRI: Magnetic resonance image; IVMP: Intravenous methylprednisolone; IVIg: Intravenous immunoglobulin; PLEX: Plasmapheresis / plasma exchange; SD: speech dysfunction; Sz: Seizure.