Herpes simplex encephalitis relapse with chorea is associated with autoantibodies to N‐Methyl‐D‐aspartate receptor or dopamine‐2 receptor. Issue 1 (1st October 2013)

• Record Type: Journal Article
• Authors: Mohammad, Shekeeb S.; Sinclair, Kate; Pillai, Sekhar; Merheb, Vera; Aumann, Tim D.; Gill, Deepak; Dale, Russell C.; Brilot, Fabienne
• Is Part Of: Movement disorders. Volume 29:Issue 1(2013)
• Page Start: 117
• Page End: 122
• Publication Date: 2013-10-01
• Subjects: Movement disorders -- Periodicals; 610
• DOI: 10.1002/mds.25623
• Languages: English
• ISSNs: 0885-3185

Abstract

<abstract abstract-type="main"> <title>ABSTRACT</title> <sec id="mds25623-sec-0001" sec-type="section"> <title>Background</title> <p>Movement disorder relapses after herpes simplex virus 1 (HSV1) encephalitis have been hypothesized to be secondary to postviral autoimmunity. Recently, a proportion of patients with HSV1 encephalitis (HSE) were shown to produce autoantibodies against <italic>N</italic>‐methyl‐<italic>D</italic>‐aspartate receptor (NMDAR).</p> </sec> <sec id="mds25623-sec-0002" sec-type="section"> <title>Methods</title> <p>We measured autoantibodies against NMDAR and dopamine‐2 receptor (D2R) expressed at the cell surface in the stored acute serum of 9 children with HSE, 3 of whom had a relapsing course with chorea.</p> </sec> <sec id="mds25623-sec-0003" sec-type="section"> <title>Results</title> <p>The 3 patients with chorea had elevated autoantibodies against NMDAR (n = 1), D2R (n = 1), or both (n = 1), whereas patients without chorea were negative (n = 6). The prospectively identified patient with chorea and NMDAR autoantibodies improved after early treatment with steroids, intravenous immunoglobulin, and cyclophosphamide, with reduction in serum NMDAR antibody titers.</p> </sec> <sec id="mds25623-sec-0004" sec-type="section"> <title>Conclusions</title> <p>These autoantibody findings lend support to the autoimmune hypothesis and the early use of immune suppression in post‐HSE chorea. © 2013 International Parkinson and Movement Disorder Society</p> </sec> </abstract>