Characteristics of clinical relapses and patient-oriented long-term outcomes of patients with anti-N-methyl-D-aspartate receptor encephalitis.
Anti-N-methyl-D-aspartate receptor encephalitis
Patient-oriented outcome
Relapse
Syndrome
Journal
Journal of neurology
ISSN: 1432-1459
Titre abrégé: J Neurol
Pays: Germany
ID NLM: 0423161
Informations de publication
Date de publication:
May 2022
May 2022
Historique:
received:
31
03
2021
accepted:
27
09
2021
revised:
07
08
2021
pubmed:
7
10
2021
medline:
23
4
2022
entrez:
6
10
2021
Statut:
ppublish
Résumé
The main syndrome of anti-N-methyl-D-aspartate receptor encephalitis (NMDARE) is well-characterized, however, the difference in main symptoms between the initial episode and relapses and patient-oriented long-term outcomes has not been previously described. To investigate the difference in syndrome symptoms between episodes and patient-oriented outcomes, we administered a structured questionnaire survey for the patients with anti-NMDARE or their family members. From the answers, we analyzed the frequency of main symptoms (e.g., prodromes, abnormal behaviors, memory deficit, speech disorders, involuntary movements, hypo-ventilation) between episodes and patient-oriented outcomes that included the recovery rate for return to previous work or school. Fifty-six patients were enrolled, and 14 (25%) showed clinical relapse. Details of symptoms at relapse were obtained from 11 patients. Prodrome (27% vs. 96%, p < 0.001), decreased level of consciousness (55% vs. 88%, p = 0.021), seizures (36% vs. 77%, p = 0.012), and involuntary movements (27% vs. 84%, p < 0.001) were significantly less frequent at relapse than initial episode. Although 80% (35/44) of the patients achieved favorable long-term outcomes (modified Rankin Scale score, 0-2), only 61% (27/44) returned to their previous work or school life. Anti-NMDARE can relapse with milder and more limited symptoms than those of initial episode, and some patients did not return to their previous activities even after achieving a neurologically favorable outcome.
Identifiants
pubmed: 34613453
doi: 10.1007/s00415-021-10828-8
pii: 10.1007/s00415-021-10828-8
doi:
Substances chimiques
Receptors, N-Methyl-D-Aspartate
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2486-2492Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.
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