New-Onset Headache in Patients With Autoimmune Encephalitis Is Associated With anti-NMDA-Receptor Antibodies

2016 ◽  
Vol 56 (6) ◽  
pp. 995-1003 ◽  
Author(s):  
Christoph J. Schankin ◽  
Fabian Kästele ◽  
Lisa Ann Gerdes ◽  
Tobias Winkler ◽  
Endy Csanadi ◽  
...  
Keyword(s):  
Nmda Receptor ◽  
Autoimmune Encephalitis ◽  
Receptor Antibodies ◽  
New Onset

scholarly journals NMDA-receptor antibodies alter cortical microcircuit dynamics

2017 ◽  
Author(s):  
RE Rosch ◽  
S Wright ◽  
G Cooray ◽  
M Papadopoulou ◽  
S Goyal ◽  
...  
Keyword(s):  
Nmda Receptor ◽  
Mouse Model ◽  
Spectral Composition ◽  
Field Potential ◽  
Autoimmune Encephalitis ◽  
Neuronal Population ◽  
Diverse Range ◽  
Excitatory Neurotransmitter ◽  
Eeg Abnormalities ◽  
Receptor Antibodies

AbstractNMDA-receptor antibodies (NMDAR-Ab) cause an autoimmune encephalitis with a diverse range of electroencephalographic (EEG) abnormalities. NMDAR-Ab are believed to disrupt receptor function, but how blocking this excitatory neurotransmitter can lead to paroxysmal EEG abnormalities – or even seizures – is poorly understood. Here, we show that NMDAR-Ab change intrinsic cortical connections and neuronal population dynamics to alter the spectral composition of spontaneous EEG activity, and predispose to paroxysmal EEG abnormalities. Based on local field potential recordings in a mouse model, we first validate a dynamic causal model of NMDAR-Ab effects on cortical microcircuitry. Using this model, we then identify the key synaptic parameters that best explain EEG paroxysms in paediatric patients with NMDAR-Ab encephalitis. Finally, we use the mouse model to show that NMDAR-Ab- related changes render microcircuitry critically susceptible to overt EEG paroxysms, when these key parameters are changed. These findings offer mechanistic insights into circuit-level dysfunction induced by NMDAR-Ab.

scholarly journals Anti-N-Methyl-D-Aspartate Encephalitis as Paraneoplastic Manifestation of Germ-Cells Tumours: A Cases Report and Literature Review

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Claudia Geraldine Rita ◽  
Israel Nieto Gañan ◽  
Adriano Jimenez Escrig ◽  
Ángela Carrasco Sayalero
Keyword(s):  
Nmda Receptor ◽  
Germ Cell ◽  
Germ Cells ◽  
Germ Cell Tumour ◽  
Clinical Manifestations ◽  
Autoimmune Encephalitis ◽  
Cell Tumour ◽  
Ovarian Teratoma ◽  
Surgical Removal ◽  
Receptor Antibodies

Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is the most common form of autoimmune encephalitis, caused by the interaction between an antibody and its target, located on glutamate receptor type N-methyl-D-aspartate (NMDA) of neuronal surface. There is a wide spectrum of clinical features starting by a viral-like prodrome, followed by symptoms such as psychosis, aggressive behaviour, memory loss, seizures, movement disorders, and autonomic instability. Up to 50% of the affected young female patients have germ-cells tumours as ovarian teratoma, making it essential to establish an early diagnosis through detection of specific antibodies in serum and cerebrospinal fluid (CSF). This retrospective observational study was performed in patients whom positive anti-NMDA receptor antibodies have been tested, associated with clinical manifestations that suggest autoimmune encephalitis and a germ-cell tumour confirmed by pathology. Six patients have tested positive for anti-NMDA receptor antibodies associated with a germ-cell tumour and clinical manifestations of autoimmune encephalitis. Management includes aggressive immunosuppression and surgical removal.

Malignant tumors in autoimmune encephalitis with anti-NMDA receptor antibodies

2018 ◽  
Vol 265 (10) ◽  
pp. 2190-2200 ◽  
Author(s):  
Chloé Bost ◽  
Eve Chanson ◽  
Géraldine Picard ◽  
David Meyronet ◽  
Marie-Eve Mayeur ◽  
...  
Keyword(s):  
Nmda Receptor ◽  
Malignant Tumors ◽  
Autoimmune Encephalitis ◽  
Receptor Antibodies

scholarly journals Atypical Association of Autoimmune Limbic Encephalitis with Anti-NMDA Receptor Antibodies in a Young Male Patient: Clinical, Imaging, and Neuropsychological Characteristics

2021 ◽  
pp. 541-548
Author(s):  
José Alberto Choreño-Parra ◽  
Tania de la Rosa-Arredondo ◽  
André Garibay-Gracián ◽  
Ingrid Montes de Oca-Vargas ◽  
Deyanira Capi-Casillas ◽  
...  
Keyword(s):  
Nmda Receptor ◽  
Limbic Encephalitis ◽  
Psychiatric Symptoms ◽  
Brain Mri ◽  
Clinical Manifestations ◽  
Memory Loss ◽  
Autoimmune Encephalitis ◽  
Young Male ◽  
Autoimmune Limbic Encephalitis ◽  
Receptor Antibodies

The spectrum of autoimmune encephalitis (AE) encompasses several entities characterized by a variable frequency of psychiatric symptoms, cognitive dysfunction, focal deficits, and seizures. Although patients with AE can be categorized in specific syndromes, overlapping manifestations are also common. Furthermore, atypical correlations between clinical phenotypes and autoantibody profiles could occur in rare cases. Here, we report the rare case of a young adult man attending due to new-onset seizures and a history of memory loss, autonomic disturbances, headache, behavioral changes, and visual and olfactory hallucinations. The patient was subjected to a complete diagnostic approach that included a comprehensive laboratory workup, neuropsychological testing, electroencephalogram, cerebrospinal fluid (CSF) analysis, brain MRI, and positron emission tomography/computed tomography scan that revealed a functional and structural compromise of the bilateral medial temporal lobes. Together with the clinical manifestations of the patient, these findings were compatible with the diagnosis of autoimmune limbic encephalitis (ALE). Strikingly, further analysis of the CSF showed autoantibodies against the N-methyl-D-aspartate (NMDA) receptor. We found very few cases of the co-occurrence of anti-NMDA receptor antibodies and nonparaneoplastic ALE in the literature, especially in male patients. Our report exemplifies the complicated differential diagnosis of ALE and adds clinical information of the association with anti-NMDA receptor antibodies.

scholarly journals NMDA-receptor antibodies alter cortical microcircuit dynamics

2018 ◽  
Vol 115 (42) ◽  
pp. E9916-E9925 ◽  
Author(s):  
Richard E. Rosch ◽  
Sukhvir Wright ◽  
Gerald Cooray ◽  
Margarita Papadopoulou ◽  
Sushma Goyal ◽  
...  
Keyword(s):  
Nmda Receptor ◽  
Mouse Model ◽  
Spectral Composition ◽  
Field Potential ◽  
Autoimmune Encephalitis ◽  
Neuronal Population ◽  
Diverse Range ◽  
Eeg Abnormalities ◽  
Synaptic Parameters ◽  
Receptor Antibodies

NMDA-receptor antibodies (NMDAR-Abs) cause an autoimmune encephalitis with a diverse range of EEG abnormalities. NMDAR-Abs are believed to disrupt receptor function, but how blocking this excitatory synaptic receptor can lead to paroxysmal EEG abnormalities—or even seizures—is poorly understood. Here we show that NMDAR-Abs change intrinsic cortical connections and neuronal population dynamics to alter the spectral composition of spontaneous EEG activity and predispose brain dynamics to paroxysmal abnormalities. Based on local field potential recordings in a mouse model, we first validate a dynamic causal model of NMDAR-Ab effects on cortical microcircuitry. Using this model, we then identify the key synaptic parameters that best explain EEG paroxysms in pediatric patients with NMDAR-Ab encephalitis. Finally, we use the mouse model to show that NMDAR-Ab–related changes render microcircuitry critically susceptible to overt EEG paroxysms when these key parameters are changed, even though the same parameter fluctuations are tolerated in the in silico model of the control condition. These findings offer mechanistic insights into circuit-level dysfunction induced by NMDAR-Ab.

scholarly journals Solitary juxtacortical lesion associated with anti-N-methyl-D-aspartate receptor encephalitis: a case report

BMC Neurology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Rupan Gao ◽  
Xiang Zhang ◽  
Abhijeet Kumar Bhekharee ◽  
Yue Zhang
Keyword(s):  
Nmda Receptor ◽  
Frontal Lobe ◽  
Brain Mri ◽  
Brain Lesion ◽  
Autoimmune Encephalitis ◽  
Left Frontal Lobe ◽  
Solitary Lesion ◽  
Nmda Receptor Encephalitis ◽  
Epileptiform Discharges ◽  
Receptor Antibodies

Abstract Background Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is a severe autoimmune encephalitis mediated by anti-NMDA receptor antibodies. Brain MRI manifestations vary and are non-specific. If there are any lesions, they tend to be diffusely or multifocally distributed. Solitary lesion is relatively rare. Case presentation We report a 16-year-old girl who initially presented with focal seizures but developed severe psychiatric and extrapyramidal symptoms later on. Brain MRI revealed a solitary juxtacortical demyelinating lesion in the left frontal lobe. No enhancement was noted. Electroencephalogram captured epileptiform discharges in the same region. NMDAR IgGs were tested positive in the serum and cerebrospinal fluid. Corticosteroid and intravenous IgG were administered and the patient completely recovered. Brain MRI revealed a fainter lesion in the left frontal lobe. Conclusion In very rare instances, anti-NMDA receptor encephalitis can present with a solitary brain lesion. A full panel of antibodies for autoimmune encephalitis is the key leading to the diagnosis.

Sign in / Sign up

Export Citation Format

Share Document