Autoimmune encephalitis mediated by antibodies against the N-methyl-D-aspartate receptor: report of four cases in Peru
DOI:
https://doi.org/10.17843/rpmesp.2019.361.3936Keywords:
Case reports, N-Methyl-D-aspartate antirreceptor encephalitis, PeruAbstract
Autoimmune encephalitis with antibodies against the N-methyl-D-aspartate receptor (anti-NMDAR) is a disorder mediated by antibodies against neural surface antigens, whose early diagnosis and timely treatment improve the prognosis of the disease. Four cases with the definitive diagnosis of autoimmune encephalitis by anti-NMDAR are presented, treated at the National Institute of Neurological Sciences in Lima-Peru. All patients had epileptic seizures and three cases developed a refractory epileptic state. In addition, three patients presented neuropsychiatric alterations, dyskinesias, and dysautonomia. Two cases required ventilatory support. All presented an abnormal electroencephalogram; two cases had pleocytosis in cerebrospinal fluid, and only one showed brain abnormalities on MRI. Regarding treatment, all patients received methylprednisolone immunotherapy and only two of them required plasma exchange for an ineffective response to corticosteroid treatment. After 12 months of hospital discharge, three patients were free of epileptic seizures and only one case did not achieve functional independence. These cases show that anti-NMDAR encephalitis is a treatable condition and its early recognition together with appropriate treatment (immunotherapy/plasmapheresis) are essential for a favorable evolution.Downloads
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Published
2019-03-20
Issue
Section
Case Report
How to Cite
1.
Palomino-Lescano H, Segura-Chávez D, Quispe-Orozco D, Castro-Suarez S, De la Cruz W, Zapata-Luyo W, et al. Autoimmune encephalitis mediated by antibodies against the N-methyl-D-aspartate receptor: report of four cases in Peru. Rev Peru Med Exp Salud Publica [Internet]. 2019 Mar. 20 [cited 2024 Nov. 3];36(1):138-44. Available from: https://rpmesp.ins.gob.pe/index.php/rpmesp/article/view/3936