Encéphalites auto-immunes à anticorps antirécepteurs-NMDA, une cause fréquente d’encéphalite en réanimation

Long‐term outcome of paediatric anti‐N‐methyl‐D‐aspartate receptor encephalitis

“…Anti‐ N ‐methyl‐ d ‐aspartate receptor encephalitis (NMDAR‐E) is the second most common autoimmune aetiology of encephalitis behind acute disseminated encephalomyelitis 1,2 . Diagnosis is suspected on the basis of associated symptoms including abnormal behaviour, cognitive impairment, decreased consciousness, abnormal movements, seizures, and autonomic dysfunction or central hypoventilation, and is confirmed by the presence of anti‐NMDAR antibodies in the cerebrospinal fluid (CSF) 3–5 . In 60% of cases, investigations such as brain imaging may be normal, and although electroencephalogram (EEG) abnormalities are common, these are non‐specific; sometimes EEGs show a pattern called ‘extreme delta brush’ combining delta waves and superimposed fast activities 3,6–11 …”

“…1,2 Diagnosis is suspected on the basis of associated symptoms including abnormal behaviour, cognitive impairment, decreased consciousness, abnormal movements, seizures, and autonomic dysfunction or central hypoventilation, and is confirmed by the presence of anti-NMDAR antibodies in the cerebrospinal fluid (CSF). [3][4][5] In 60% of cases, investigations such as brain imaging may be normal, and although electroencephalogram (EEG) abnormalities are common, these are non-specific; sometimes EEGs show a pattern called 'extreme delta brush' combining delta waves and superimposed fast activities. 3,[6][7][8][9][10][11] No standardized therapeutic recommendations exist, but treatment should be initiated early and remains a major factor for a good prognosis.…”