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| dc.contributor.author | Titulaer, Maarten J. |
|---|---|
| dc.contributor.author | Höftberger, Romana |
| dc.contributor.author | Iizuka, Takahiro |
| dc.contributor.author | Leypoldt, Frank |
| dc.contributor.author | McCracken, Lindsey |
| dc.contributor.author | Cellucci, Tania |
| dc.contributor.author | Benson, Leslie A. |
| dc.contributor.author | Shu, Huidy |
| dc.contributor.author | Irioka, Takashi |
| dc.contributor.author | Hirano, Makito |
| dc.contributor.author | Singh, Gagandeep |
| dc.contributor.author | Cobo Calvo, Álvaro |
| dc.contributor.author | Kaida, Kenichi |
| dc.contributor.author | Morales, Pamela S. |
| dc.contributor.author | Wirtz, Paul W. |
| dc.contributor.author | Yamamoto, Tomotaka |
| dc.contributor.author | Reindl, Markus |
| dc.contributor.author | Rosenfeld, Myrna R. |
| dc.contributor.author | Graus Ribas, Francesc |
| dc.contributor.author | Saiz Hinajeros, Albert |
| dc.contributor.author | Dalmau Obrador, Josep |
| dc.date | 2018-11-08T15:10:34Z |
| dc.date | 2018-11-08T15:10:34Z |
| dc.date | 2014-02-11 |
| dc.date | 2018-11-08T15:10:34Z |
| dc.identifier | 0364-5134 |
| dc.identifier | 654289 |
| dc.identifier | 24700511 |
| dc.identifier.uri | http://hdl.handle.net/2445/125927 |
| dc.description | Objective: To report the clinical, radiological, and immunological association of demyelinating disorders with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. Methods: Clinical and radiological analysis was done of a cohort of 691 patients with anti-NMDAR encephalitis. Determination of antibodies to NMDAR, aquaporin-4 (AQP4), and myelin oligodendrocyte glycoprotein (MOG) was performed using brain immunohistochemistry and cell-based assays. Results: Twenty-three of 691 patients with anti-NMDAR encephalitis had prominent magnetic resonance imaging (MRI) and/or clinical features of demyelination. Group 1 included 12 patients in whom anti-NMDAR encephalitis was preceded or followed by independent episodes of neuromyelitis optica (NMO) spectrum disorder (5 cases, 4 anti-AQP4 positive) or brainstem or multifocal demyelinating syndromes (7 cases, all anti-MOG positive). Group 2 included 11 patients in whom anti-NMDAR encephalitis occurred simultaneously with MRI and symptoms compatible with demyelination (5 AQ4 positive, 2 MOG positive). Group 3 (136 controls) included 50 randomly selected patients with typical anti-NMDAR encephalitis, 56 with NMO, and 30 with multiple sclerosis; NMDAR antibodies were detected only in the 50 anti-NMDAR patients, MOG antibodies in 3 of 50 anti-NMDAR and 1 of 56 NMO patients, and AQP4 antibodies in 48 of 56 NMO and 1 of 50 anti-NMDAR patients (p < 0.0001 for all comparisons with Groups 1 and 2). Most patients improved with immunotherapy, but compared with anti-NMDAR encephalitis the demyelinating episodes required more intensive therapy and resulted in more residual deficits. Only 1 of 23 NMDAR patients with signs of demyelination had ovarian teratoma compared with 18 of 50 anti-NMDAR controls (p = 0.011). Interpretation: Patients with anti-NMDAR encephalitis may develop concurrent or separate episodes of demyelinating disorders, and conversely patients with NMO or demyelinating disorders with atypical symptoms (eg, dyskinesias, psychosis) may have anti-NMDAR encephalitis. |
| dc.format | 18 p. |
| dc.format | application/pdf |
| dc.language | eng |
| dc.publisher | Wiley-Liss |
| dc.relation | Versió postprint del document publicat a: https://doi.org/10.1002/ana.24117 |
| dc.relation | Annals of Neurology, 2014, vol. 75, num. 3, p. 411-428 |
| dc.relation | https://doi.org/10.1002/ana.24117 |
| dc.rights | (c) American Neurological Association, 2014 |
| dc.rights | info:eu-repo/semantics/openAccess |
| dc.subject | Encefalitis |
| dc.subject | Receptors cel·lulars |
| dc.subject | Encephalitis |
| dc.subject | Cell receptors |
| dc.title | Overlapping demyelinating syndromes and anti-NMDA receptor encephalitis |
| dc.type | info:eu-repo/semantics/article |
| dc.type | info:eu-repo/semantics/acceptedVersion |
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