Long‐term outcome of paediatric anti‐N‐methyl‐D‐aspartate receptor encephalitis. (5th October 2022)

• Record Type: Journal Article
• Authors: Flet‐Berliac, Lorraine; Tchitchek, Nicolas; Lépine, Anne; Florea, Anca; Maurey, Hélène; Chrétien, Pascale; Hacein‐Bey‐Abina, Salima; Villega, Frederic; Cheuret, Emmanuel; Rogemond, Véronique; Picard, Géraldine; Honnorat, Jérôme; Deiva, Kumaran
• Is Part Of: Developmental medicine & child neurology. Volume 65:Number 5(2023)
• Page Start: 691
• Page End: 700
• Publication Date: 2022-10-05
• Subjects: Child development -- Periodicals; Pediatric neurology -- Periodicals; 616.8
• DOI: 10.1111/dmcn.15429
• Languages: English
• ISSNs: 0012-1622

Abstract

Abstract: Aim: To study long‐term clinical and cognitive outcomes of patients with anti‐ N ‐methyl‐d ‐aspartate receptor encephalitis (NMDAR‐E), an acute autoimmune neurological disease with severe acute presentations. Method: In this French multicentre retrospective observational cohort study, patients no older than 18 years with a follow‐up of at least 2 years were included. Data from clinical and cognitive assessments were collected. Results: Eighty‐one patients were included (57 females, 24 males; median age 10 years 7 months [range 1–18 years], median follow‐up 40 months [range 25–53 months]). At last follow‐up, 35 patients (45%) had cognitive impairment, 48 (70%) had academic difficulties, and 65 (92%) needed rehabilitation. Seventy‐one patients (88%) had a modified Rankin Scale score of no more than 2. A higher number of symptoms at diagnosis was associated with cognitive impairment ( p = 0.01), while an abnormal electroencephalogram at diagnosis increased the risk of academic difficulties ( p = 0.03). Interpretation: Although most children with NMDAR‐E seemed to recover from motor disabilities, more than 45% had cognitive and academic difficulties. The initial severity of symptoms seems to have an impact on cognition and academic performances. What this paper adds: Forty‐five per cent of patients had cognitive impairment at ≥2 years diagnosis of anti‐ N ‐methyl‐d ‐aspartate receptor encephalitis (NMDAR‐E). Seventy per cent of patients had academic difficulties at ≥2 years diagnosis of NMDAR‐E. Ninety‐two per cent of patients needed rehabilitative care at ≥2 years diagnosis of NMDAR‐E. A high number of symptoms at diagnosis were associated with cognitive impairment. What this paper adds: Forty‐five per cent of patients had cognitive impairment at ≥2 years diagnosis of anti‐ N ‐methyl‐d ‐aspartate receptor encephalitis (NMDAR‐E). Seventy per cent of patients had academic difficulties at ≥2 years diagnosis of NMDAR‐E. Ninety‐two per cent of patients needed rehabilitative care at ≥2 years diagnosis of NMDAR‐E. A high number of symptoms at diagnosis were associated with cognitive impairment.