A case of NMDAR encephalitis treated in the third trimester - novel arterial spin labeling findings and a review of literature

Jung, Kyu-On; Moon, Hye-Jin

doi:10.1016/j.jneuroim.2020.577235

Cited by 9 publications

(6 citation statements)

References 28 publications

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“…According to Newcastle–Ottawa Quality Assessment Scale (NOS), 16 articles received a score of 5, 19 articles had a score of 4, and 5 articles were scored 3 (score results in detail are shown in Table S4). Details of the included articles are reported in Table 1 7,12–51 …”

Section: Resultsmentioning

confidence: 99%

Autoimmune encephalitis during pregnancy: A diagnostic and therapeutic challenge—A systematic review with individual patients' analysis and clinical recommendations

et al. 2023

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SUMMARYSeveral reports have described the autoimmune encephalitis’ (AE) possible onset during pregnancy. In this systematic review, we summarize the available data on the diagnostic and therapeutic approach to AE during pregnancy, highlighting the associated maternal and fetal clinical outcomes. A systematic search of the literature was performed. The following databases were used: Pubmed, Google Scholar, EMBASE, CrossRef. The revision was registered on the PROSPERO platform (CRD42022336357). Forty‐nine patients were included. AE onset was mainly observed during the first and the second trimester of pregnancy with psychiatric manifestations and seizures as main onset symptoms. CSF analysis showed AE‐specific autoantibody positivity in 33 patients (anti‐NMDA receptor as the most frequent). EEG generally showed normal findings. MRI revealed pathological findings in less than half of patients. Tumor screening was positive findings in 14 cases. First line immunotherapy (single or combined) was generally employed while second line was administered in a minority of patients. Levetiracetam was the most used antiseizure medication. Cesarean section was performed in 18 women. Most of the women had an excellent early outcome after delivery but 22 showed persistent neurological deficits in long‐term follow‐up. Fetal outcome was positive in 33 cases whereas 12 cases of fetal death were reported. A logistic regression showed that no variable significantly influenced the odds of good/bad maternal and fetal clinical outcome. Diagnosis and treatment of AE during pregnancy is challenging. The rate of miscarriage in women with AE seems to be higher than the general population. In addition, mothers may show long‐term neurological deficits.

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Section: Resultsmentioning

confidence: 99%

Autoimmune encephalitis during pregnancy: A diagnostic and therapeutic challenge—A systematic review with individual patients' analysis and clinical recommendations

et al. 2023

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“…In our cohort, one patient was diagnosed with AE during pregnancy and improved clinically after a Cesarean section even without immunotherapy. Other case reports have also shown that clinical improvement may be related to delivery or that delivery seemed to accelerate recovery [13][14][15].…”

Section: Discussionmentioning

confidence: 95%

“…Anti-NMDAR encephalitis has rarely been reported during pregnancy [13][14][15], and the diagnosis and treatment are challenging due to concerns over the safety of the mother and fetus. Pregnancy-related SE caused by AE is also rare [16,17].…”

Section: Discussionmentioning

confidence: 99%

Validating Prediction Tools for Autoimmune Encephalitis in Adult Taiwanese Patients: A Retrospective Study

Lin

et al. 2023

Biomedicines

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Autoimmune encephalitis (AE) is a neurological emergency. We aimed to analyze the application and effectiveness of the currently available prediction tools for AE patients in Taiwan. We retrospectively collected 27 AE patients between January 2008 and December 2019. Antibody Prevalence in Epilepsy (APE) score, Response to Immunotherapy in Epilepsy (RITE) score, and anti-NMDAR Encephalitis One Year Functional Status (NEOS) score were applied to validate their usability. Based on the defined cutoff values, the sensitivity and specificity of each score were calculated. A receiver operating characteristic (ROC) curve and the area under the curve (AUC) were generated for each scoring system. The AUC value of APE was 0.571. The AUC value of RITE was 0.550. The AUC values for the NEOS score at discharge and long-term follow-up were 0.645 and 0.796, respectively. The performance of APE and RITE scores was suboptimal in the Taiwanese cohort, probably due to the limitations of the small sample size and single ethnicity. On the other hand, the NEOS score performed better on long-term follow-up than at discharge.

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“… Normal baby Joubert et al [20] 2020 23 8 Nausea, visual hallucination, delirium Yes Not tested IVIg, Resection of teratoma Normal C-section. Low birth weigh Keskin et al [32] 2019 27 18 Seizure, headache, visual hallucination No Not tested IVIg IV-Methylprednisolone, PLEX Death Death Jung et al [33] 2020 28 24 Depression, focal seizure, headache No Not tested IVIg Oral corticosteroids IV-Methylprednisolone RTX Normal C-section. Normal baby Tailland et al [34] 2020 37 18 Orofacial dyskinesia, pyramidal bilateral syndrome No Not tested IVIg IV-Methylprednisolone Not available Normal …”

Section: Discussionmentioning

confidence: 99%

Anti N-methyl-D-aspartate receptor (NMDAr) encephalitis during pregnancy: A case report

Evangelista

Consoli

Scorrano

et al. 2022

Epilepsy & Behavior Reports

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A case of NMDAR encephalitis treated in the third trimester - novel arterial spin labeling findings and a review of literature

Cited by 9 publications

References 28 publications

Autoimmune encephalitis during pregnancy: A diagnostic and therapeutic challenge—A systematic review with individual patients' analysis and clinical recommendations

Autoimmune encephalitis during pregnancy: A diagnostic and therapeutic challenge—A systematic review with individual patients' analysis and clinical recommendations

Validating Prediction Tools for Autoimmune Encephalitis in Adult Taiwanese Patients: A Retrospective Study

Anti N-methyl-D-aspartate receptor (NMDAr) encephalitis during pregnancy: A case report

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