Journal of Clinical Pediatrics ›› 2020, Vol. 38 ›› Issue (5): 367-.doi: 10.3969/j.issn.1000-3606.2020.05.013

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Clinical characteristics of children with anti-NMDAR encephalitis and its impact on prognosis

 XU Xuanxuan, JIN Peina, MA Wei, WANG Huaili   

  1. The First Affiliated Hospital of Zhengzhou University, PICU, Zhengzhou 450052, Henan, China
  • Online:2020-05-15 Published:2020-06-02

Abstract: Objective To analyze the characteristics of anti-NMDAR (N-methyl-D-aspartate receptor) encephalitis in children and to explore the effect of seizures against NMDAR encephalitis. Methods Clinical data of 42 children with positive cerebrospinal fluid anti-NMDAR antibodies from April 2014 to January 2019 were divided into two groups according to whether there is an epileptic seizure in the acute phase, and analyzed clinically. Clinical data and the modified ranking scores (mRS) scores of the two groups were compared and effects of seizures against NMDAR encephalitis were analyzed. According to whether there were seizures during follow-up, the mRS scores of the two groups were compared, and analysis of the effect of seizures during recovery on the long-term prognosis of children were performed. Results Of the 42 children with anti-NMDAR encephalitis, 29 (69%) had epileptic seizures, including 17 (58.6%) with general seizures, 14 (48.3%) with seizures greater than 3 times, and status epilepticus in 15 patients (51.7%). Of the children without epileptic seizures, one patient (7.7%) had a seizure during the follow-up period. The number of nucleated cells in the cerebrospinal fluid between the two groups according to the presence of epilepsy in the acute phase were compared, there is significant difference (P<0.05). According to whether there were seizures during follow-up, the mRS scores of the two groups were compared, and the difference was significant (P<0.05). Conclusion  Whether children with anti-NMDAR encephalitis are accompanied by seizures in the acute phase, it has no effect on the children's EEG, skull MRI, antibody titer, whether seizures recur in the recovery period and long-term prognosis. The long-term prognosis of children with seizures during the recovery period is poor.

Key words:  seizures; anti-NMDAR encephalitis; antibody titer; prognosis