Anti-N-Methyl-D-Aspartate Receptor Antibody Mediated Neurologic Relapse Post Herpes Simplex Encephalitis

Geoghegan, Sarah; Walsh, A Valladolid; King, Mary D.; Lynch, Bryan; Webb, David; Twomey, Eilish; Leahy, T. Ronan; Butler, Karina; Gavin, Patrick J.

doi:10.1097/inf.0000000000001205

Cited by 9 publications

(11 citation statements)

References 23 publications

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Section: Resultsmentioning

confidence: 99%

“…Our literature search led to the identification of 20 articles, published between 2013 and 2016, reporting a total of 42 patients who experienced biphasic disease with HSE followed by HSV-induced anti-NMDAR encephalitis. [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] The full text of all articles was available. With the addition of our case, a total of 43 patients with biphasic disease with HSE followed by HSV-induced anti-NMDAR encephalitis were identified (31 children).…”

Section: Literature Review Biphasic Illness: Hse Followed By Hsv-indumentioning

confidence: 99%

“…In these patients, duration of antiviral treatment from anti-NMDAR encephalitis was less than or equal to 7 days in 23% (n=5/22) and greater than or equal to 14 days in the remaining 77% (n=17/22) (data available for n=22/33); only four patients (n=4/22; 18%) received a prolonged course with oral valaciclovir/aciclovir (for 122d, 152d, 153d, and 243d respectively). 20,24,31 During the episode of anti-NMDAR encephalitis, first-and second-line immune therapies were administered in 93% (n=38/41) and 53% (n=21/40) of patients respectively.…”

Section: Main Differences Between Children and Adults During The Antimentioning

confidence: 99%

“…61,62 In this respect, it is noteworthy that in our literature cohort none of the patients treated with immune therapy for HSV-induced anti-NMDAR encephalitis (or for HSE) was reported to have recurrence of HSE, despite only very few receiving long-term antiviral therapy. 20,24,31 Moreover, the beneficial effect of adjunctive steroids in HSE has been anecdotally described both in paediatric and adult age, [63][64][65][66] and in an experimental study on a mouse model of HSE, the severity of long-term MRI anti-N-methyl-D-aspartate receptor (NMDAR) abnormalities was significantly reduced with add-on corticosteroids during acute HSE. 62 The optimal timing for adjunctive steroid therapy has not yet been established, 65 and while in some cases a beneficial effect has been reported after early simultaneous administration of aciclovir and steroids, 64 in other cases steroid administration was delayed by a few days to weeks, with good results.…”

Section: Insights Into the Use Of Immune Therapy In Hsementioning

confidence: 99%

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Herpes simplex virus‐induced anti‐N‐methyl‐d‐aspartate receptor encephalitis: a systematic literature review with analysis of 43 cases

Nosadini

Mohammad

Corazza

et al. 2017

Develop Med Child Neuro

137

103

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Our review suggests that movement disorder may help differentiate clinically an episode of HSV-induced anti-NMDAR encephalitis from HSE relapse. Compared with adults, children have shorter latency between HSE and anti-NMDAR encephalitis and, during anti-NMDAR encephalitis, more movement disorder, fewer psychiatric symptoms, and slightly more severe disease. According to our results, immune therapy given for HSV-induced anti-NMDAR encephalitis does not predispose patients to HSE recurrence.

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Section: Resultsmentioning

confidence: 99%

Section: Literature Review Biphasic Illness: Hse Followed By Hsv-indumentioning

confidence: 99%

Section: Main Differences Between Children and Adults During The Antimentioning

confidence: 99%

Section: Insights Into the Use Of Immune Therapy In Hsementioning

confidence: 99%

See 2 more Smart Citations

Herpes simplex virus‐induced anti‐N‐methyl‐d‐aspartate receptor encephalitis: a systematic literature review with analysis of 43 cases

Nosadini

Mohammad

Corazza

et al. 2017

Develop Med Child Neuro

137

103

View full text Add to dashboard Cite

show abstract

“…Recently many reports have suggested a link between relapsing symptoms of herpes simplex viral encephalitis (HSVE) and antibodies against NMDAR . Hacohen et al reported seven children who had a neurological relapse following episode of HSVE.…”

Section: Search Resultsmentioning

confidence: 99%

Movement disorders associated with neuronal antibodies

Dash

Pandey

2018

Acta Neurol Scand

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Movement disorders are one of the common clinical features of neurological disease associated with neuronal antibodies which is a group of potentially reversible disorder. They can present with hypokinetic or hyperkinetic types of involuntary movements and may have other associated neurological symptoms. The spectrum of abnormal movements associated with neuronal antibodies is widening. Some specific phenomenology of movement disorders are likely to give clue about the type of antibody, for instance, presence of paroxysmal dystonia (facio-brachial dystonic seizures) are a pointer toward presence of LGI-1 antibodies, and orofacial lingual dyskinesia is associated with NMDAR associated encephalitis. The presence of specific type of movement disorder allows high suspicion of testing of certain specific type of antibodies. In this review, we have discussed the various antibodies and the spectrum of movement disorder associated with them, highlighting if any distinct movement disorder allows the clinician to suspect type of antibody in a certain clinical context. We have also reviewed the treatment of the movement disorder associated with the neuronal antibodies. Physicians should have high index of suspicion of these disorders, as early institution of treatment options can lead to better outcome.

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