Extreme Delta Brushes in Pediatric Anti-N-Methyl-DAspartate Receptor Encephalitis

Abstract

Anti-N-Methyl-D-Aspartate receptor (NMDAR) encephalitis is probably the most common paraneoplastic encephalitis. In children, seizures, behavioral disturbances and abnormal movements are the most frequent symptoms. Electroencephalogram is abnormal in most patients. We report a child with anti-NMDAR encephalitis presenting extreme delta brushes in the EEG. This new EEG feature is described in patients with anti-NMDAR encephalitis, mostly adults. The identification of this EEG pattern may guide to an early diagnosis and treatment of anti-NMDAR encephalitis.

Clinical variables that help in predicting the presence of autoantibodies in patients with acute encephalitis

“…Changes in the EEG are rarely specific. We recognize the use of some EEG patterns in diagnosing specific forms of encephalitis (e.g., extreme delta brush in anti-NMDAR encephalitis), which was observed in 2 of our patients, all of whom were children with positive NMDAR [4,40]. EEG was also useful in the differential diagnosis of other disorders [41] or revealed subclinical epileptic seizures and non-convulsive status epilepticus, as we have already published [30].…”