tetano
Editor, Senior Moderator
Childs Nerv Syst
. 2021 Apr 14.
doi: 10.1007/s00381-021-05155-2. Online ahead of print.
Pediatric anti-NMDA receptor encephalitis associated with COVID-19
Esra Sarigecili[SUP] 1 [/SUP], Ilknur Arslan[SUP] 2 [/SUP], Habibe Koc Ucar[SUP] 3 [/SUP], Umit Celik[SUP] 4 [/SUP]
Affiliations
Abstract
Anti-N-methyl-D-aspartate receptor encephalitis is a clinical condition characterized by acute behavioral and mood changes, abnormal movements, autonomic instability, seizures, and encephalopathy. We describe a 7-year-old boy diagnosed with autoimmune encephalitis due to NMDAR antibody in association with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease 2019) (COVID-19), without pulmonary involvement or fever. The patient presented with acute ataxia, rapidly developed encephalopathy, and autoimmune encephalitis was suspected. Steroid treatment was withheld because of lymphopenia and intravenous immunoglobulin was started. The absence of clinical response prompted plasmapheresis and, when lymphocyte counts improved, pulse steroid treatment was applied. The latter was followed by significant improvement and the patient was discharged in a conscious and ambulatory state. Autoimmune encephalitis should be considered in the presence of neurological symptoms accompanying SARS-CoV-2 infection and steroid treatment should be preferred unless limited by contraindications.
Keywords: Anti-NMDA receptor encephalitis; Ataxia; COVID-19; Pediatric.
. 2021 Apr 14.
doi: 10.1007/s00381-021-05155-2. Online ahead of print.
Pediatric anti-NMDA receptor encephalitis associated with COVID-19
Esra Sarigecili[SUP] 1 [/SUP], Ilknur Arslan[SUP] 2 [/SUP], Habibe Koc Ucar[SUP] 3 [/SUP], Umit Celik[SUP] 4 [/SUP]
Affiliations
- PMID: 33852058
- DOI: 10.1007/s00381-021-05155-2
Abstract
Anti-N-methyl-D-aspartate receptor encephalitis is a clinical condition characterized by acute behavioral and mood changes, abnormal movements, autonomic instability, seizures, and encephalopathy. We describe a 7-year-old boy diagnosed with autoimmune encephalitis due to NMDAR antibody in association with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease 2019) (COVID-19), without pulmonary involvement or fever. The patient presented with acute ataxia, rapidly developed encephalopathy, and autoimmune encephalitis was suspected. Steroid treatment was withheld because of lymphopenia and intravenous immunoglobulin was started. The absence of clinical response prompted plasmapheresis and, when lymphocyte counts improved, pulse steroid treatment was applied. The latter was followed by significant improvement and the patient was discharged in a conscious and ambulatory state. Autoimmune encephalitis should be considered in the presence of neurological symptoms accompanying SARS-CoV-2 infection and steroid treatment should be preferred unless limited by contraindications.
Keywords: Anti-NMDA receptor encephalitis; Ataxia; COVID-19; Pediatric.