CLINICAL MANIFESTATIONS OF ANTI-NMDA RECEPTOR ENCEPHALITIS IN CHILDREN
Authors:   Chair of Neurology, Neurosurgery and Medical Genetics named after L.O. Badalyan of the Pediatric Department with the Pirogov Russian National Research Medical University, Moscow, Russia, Bembeeva R.Ts. , Azizova U.M. ,   Chair of Neurology, Neurosurgery and Medical Genetics named after L.O. Badalyan of the Pediatric Department with the Pirogov Russian National Research Medical University, Moscow, Russia,   Russian Children's Clinical Hospital with the Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, Moscow, Russia, Zavadenko N.N. ,   Chair of Neurology, Neurosurgery and Medical Genetics named after L.O. Badalyan of the Pediatric Department with the Pirogov Russian National Research Medical University, Moscow, Russia, Ilyina E.S. ,   Chair of Neurology, Neurosurgery and Medical Genetics named after L.O. Badalyan of the Pediatric Department with the Pirogov Russian National Research Medical University, Moscow, Russia,   Russian Children's Clinical Hospital with the Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, Moscow, Russia, Kholin A.A. ,   Chair of Neurology, Neurosurgery and Medical Genetics named after L.O. Badalyan of the Pediatric Department with the Pirogov Russian National Research Medical University, Moscow, Russia,   Russian Children's Clinical Hospital with the Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, Moscow, Russia, Shakaryan A.K. ,   M.P. Chumakov Federal Scientific Center for Research and Development of Immune-and-Biological Products of the Russian Academy of Sciences (RAS), Moscow, Russia,   Chair of Infectious Diseases in Children of the Pediatric Department with the Pirogov Russian National Research Medical University, Moscow, Russia, Piliya S.V. ,   Russian Children's Clinical Hospital with the Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, Moscow, Russia, Mitrofanova I.V. ,   Moscow Infectious Clinical Hospital No. 1 of the Moscow Department of Healthcare, Moscow, Russia, Kursakova Yu.A. ,   Russian Children's Clinical Hospital with the Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, Moscow, Russia, Fedonyuk I.D. ,   Russian Children's Clinical Hospital with the Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, Moscow, Russia, Kolpakchi L.M. ,   Russian Children's Clinical Hospital with the Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, Moscow, Russia, Volkova E.Yu. ,   Russian Children's Clinical Hospital with the Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, Moscow, Russia, Savvin D.A. ,   Russian Children's Clinical Hospital with the Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, Moscow, Russia
Published: November 2021

The aim of the study was to determine the clinical features of anti-NMDAR encephalitis in children. Materials and methods of research: 11 patients were selected from the group of children with autoimmune encephalitis, who met the diagnostic criteria for reliable anti-NMDAR encephalitis. A retro-prospective analysis of clinical symptoms, laboratory, neurophysiological and neuroimaging data, treatment, duration of primary hospitalization and long-term results of treatment was carried out, neuropsychological testing of patients was performed in the follow-up. Results: the age of the patients was 8.5±4.4 years, the gender composition of boys/girls was 1/10 (9.1%/90.9%). The average follow-up period was 17±12 months. In 73% of cases, there was an acute onset of the disease without a prodromal phase and with rapidly growing signs of neurological dysfunction: behavior change (11/100%), epileptic seizures (11/100%), speech impairment (10/90.9%), movement disorders (10/90.9%), disturbed sleep/wakefulness rhythm (9/81.8%), hallucinations (5/45.5%), autonomic disorders (6/54.5%), sensory disturbance (1/9,1%). In 82% of cases, therapy was required in the intensive care unit. When analyzing EEG monitoring in children, the extreme delta brush pattern was revealed in only one patient. Neuroimaging revealed no specific changes in the substance of the brain. The paraneoplastic nature of the disease could not be established in any case. 4 patients (36.36%) had relapses of the disease after 1.5–27 months. from the onset of the disease. All children showed a favorable outcome without a gross neurological deficit, but complaints of increased fatigue, headaches, poor memory, a decrease in vocabulary, and impulsive behavior persisted.