Clinical variability of children with anti-N-methyl-d-aspartate receptor encephalitis in southern Brazil: a cases series and review of the literature

2018 ◽  
Vol 40 (2) ◽  
pp. 351-356 ◽  
Author(s):  
Daniel Almeida do Valle ◽  
Joselainy Stela Pires Galeazzi ◽  
Mayara de Rezende Machado ◽  
Vanessa Catarine Silva Abreu Ribeir dos Santos ◽  
Alcir Francisco da Silva ◽  
...  
Keyword(s):  
Southern Brazil ◽  
Review Of The Literature ◽  
Clinical Variability ◽  
Aspartate Receptor

Extended Duration Ketamine Infusions in Critically Ill Children: A Case Report and Review of the Literature

2020 ◽  
Author(s):  
Eszter Moore ◽  
Rebecca Mayes ◽  
Maura Harkin ◽  
Jamie L. Miller ◽  
Peter N. Johnson
Keyword(s):  
Case Report ◽  
Critically Ill ◽  
Withdrawal Symptoms ◽  
Critically Ill Children ◽  
Second Line ◽  
Review Of The Literature ◽  
Aspartate Receptor ◽  
Variable Duration ◽  
Extended Duration ◽  
Dexmedetomidine Infusion

AbstractKetamine is an N-methyl-D-aspartate receptor antagonist that has been used as an adjunct analgesic and sedative in critically ill children. Previous reports noted that ketamine has been used for a variable duration of 12 to 408 hours for this indication. We report on the use of ketamine infusions for >720 hours as a second-line sedative in addition to an opioid and dexmedetomidine infusion in a 2-month old and 17-month old. The purpose of this case report and review of the literature is to highlight the prolonged ketamine exposure of these two patients and to provide awareness to clinicians on the potential of withdrawal with extended ketamine administration. These children were started on initials doses of 5 and 15 µg/kg/min and titrated to peak doses of 20 and 25 µg/kg/min, respectively. They were continued for a total of 987 and 792 hours, respectively. No adverse events were noted during the ketamine infusions. One patient developed possible withdrawal symptoms 17 hours after ketamine discontinuation despite tapering of the infusion. These symptoms resolved with administration of as needed intravenous opioids and benzodiazepines, and the agitation normalized within 24 hours after ketamine discontinuation. Clinicians should consider tapering ketamine infusions in children receiving >72 hours of a continuous infusion by 5 µg/kg/min every 8 to 12 hours. Patients should be monitored for potential withdrawal symptoms including anxiety, allodynia, hyperalgesia, sweating, and drowsiness.

scholarly journals Anti-N-methyl-d-aspartate receptor encephalitis: review of clinical presentation, diagnosis and treatment

2015 ◽  
Vol 39 (1) ◽  
pp. 19-23 ◽  
Author(s):  
Helen Barry ◽  
Susan Byrne ◽  
Elizabeth Barrett ◽  
Kieran C. Murphy ◽  
David R. Cotter
Keyword(s):  
Nmda Receptor ◽  
Clinical Presentation ◽  
Behavioural Change ◽  
Review Of The Literature ◽  
Impaired Consciousness ◽  
Motor Disturbance ◽  
Nmda Receptor Encephalitis ◽  
Aspartate Receptor ◽  
Nr2 Subunits ◽  
Symptoms And Signs

SummaryAnti-N-methyl-d-aspartate (NMDA) receptor encephalitis is a form of encephalitis occurring primarily in women and associated with antibodies against NR1 or NR2 subunits of the NMDA receptor. As a potentially treatable differential for symptoms and signs seen in neurology and psychiatric clinics, clinicians practising across the lifespan should be aware of this form of encephalitis. Common clinical features include auditory and visual hallucinations, delusions, behavioural change (frequently with agitation), impaired consciousness, motor disturbance (ranging from dyskinesia to catatonia), seizures, and autonomic dysfunction. We present a review of the literature on the disorder, including its clinical presentation, differential diagnosis, epidemiology, treatment and prognosis.

scholarly journals Efficacy of Memantine in Schizophrenic Patients: A Systematic Review

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Giuseppe Di Iorio ◽  
Gaia Baroni ◽  
Marco Lorusso ◽  
Chiara Montemitro ◽  
Maria Chiara Spano ◽  
...  
Keyword(s):  
Systematic Review ◽  
Negative Symptoms ◽  
Positive Symptoms ◽  
Cognitive Symptoms ◽  
Review Of The Literature ◽  
Excitatory Neurotransmitter ◽  
Aspartate Receptor ◽  
Schizophrenic Patients ◽  
Promising Treatment

Several evidences support the hypothesis that glutamatergic dysfunction may be implicated in the pathogenesis of schizophrenia and in the last few years great interest has been focused on the role of the N-methyl-D-aspartate receptor (NMDAR). Glutamate is the main excitatory neurotransmitter in human CNS and it plays a prominent role in synaptic plasticity, learning, and memory and other cognitive functions. Increasing interest in memantine add-on therapy in schizophrenic patients with negative and cognitive symptoms may suggest that memantine could be a new promising treatment in schizophrenia. The aim of this update was to evaluate clinical data about the memantine effectiveness in schizophrenic patients. Our systematic review of the literature highlights that memantine therapy in schizophrenic patients seems to improve mainly negative symptoms while positive symptoms and cognitive symptoms did not improve significantly.

Anti–N-methyl-D-aspartate Receptor-Mediated Encephalitis in Infants and Toddlers: Case Report and Review of the Literature

2014 ◽  
Vol 50 (2) ◽  
pp. 181-184 ◽  
Author(s):  
Ethan M. Goldberg ◽  
Maarten Titulaer ◽  
Peter M. de Blank ◽  
Angela Sievert ◽  
Nicole Ryan
Keyword(s):  
Case Report ◽  
Infants And Toddlers ◽  
Review Of The Literature ◽  
Aspartate Receptor

Clinical variability in multifocal lymphangioendotheliomatosis with thrombocytopenia: a review of the literature

2021 ◽  
pp. 1-13
Author(s):  
Joshua Manor ◽  
Kalyani Patel ◽  
Ionela Iacobas ◽  
Judith F. Margolin ◽  
Priya Mahajan
Keyword(s):  
Review Of The Literature ◽  
Clinical Variability

Innovation in Scenario Building

2012 ◽  
pp. 302-325
Author(s):  
Ariane Hinça Schneider ◽  
Laila Del Bem Seleme ◽  
Felipe Fontes Rodrigues ◽  
Marilia de Souza ◽  
Helio Gomes de Carvalho
Keyword(s):  
National Economy ◽  
Document Analysis ◽  
Data Sources ◽  
Metropolitan Region ◽  
Automotive Sector ◽  
Southern Brazil ◽  
Review Of The Literature ◽  
Structured Interviews ◽  
Scenario Building ◽  
New Approach

Situated in Paraná state in southern Brazil, the Metropolitan Region of Curitiba (MRC) is home to an automotive sector which plays a major role in the local and national economy. In order to expand the development of the automotive sector and to create new local and worldwide opportunities, the Federation of Industries of Paraná (FIEP) developed and employed an innovative scenario building methodology to analyze the automotive industry’s potential for innovation and attendance of new market demands for 2020; which is Sector Foresight. Therefore, results allow the players to have a clearer managerial view of the industry’s possible future. This chapter seeks to publicize the experience as well as the results of this innovative project by focusing on the methodology and tools. Data sources included a review of the literature, document analysis, direct observation, semi-structured interviews and two rounds of questionnaires. This experience contributed to innovate the organizational and methodological processes of FIEP, and to improve the perspective of innovation in the automotive sector through a new approach to scenario building. Results also shown this methodology can be applied to other industries in future studies.

Critical Analysis of a Challenging Case of Post-Infectious N-Methyl-D-Aspartate Receptor Encephalitis

2020 ◽  
pp. 194187442096435
Author(s):  
Samantha Epstein ◽  
Jyoti Ankam ◽  
Wendy S. Vargas ◽  
Kiran T. Thakur
Keyword(s):  
Autoimmune Disease ◽  
Critical Analysis ◽  
Autoimmune Encephalitis ◽  
Behavioral Changes ◽  
Psychiatric Disease ◽  
Review Of The Literature ◽  
Literature Research ◽  
Aspartate Receptor ◽  
Neuronal Autoantibodies ◽  
Post Infectious

Infections are increasingly recognized as a common trigger of autoimmune disease, including autoimmune encephalitis. A significant association is particularly shown between HSV-1 encephalitis (HSVE) and a post-infectious autoimmune encephalitis mediated by neuronal autoantibodies, most notably anti-N-methyl-D-aspartate receptor (NMDAR) antibodies. The clinical significance of these and other novel post-infectious autoantibodies has led to new diagnostic and treatment challenges for clinicians. Here we present a case of a 19-year-old female with premorbid psychiatric disease and neuropsychiatric sequelae from HSVE who presented over a year after her initial HSVE with behavioral changes and positive anti-NMDAR antibodies. The clinical challenges encountered during this case are explored in detail based on a review of the literature. Research is needed to help guide management in these complex clinical situations.

scholarly journals Recurrent anti-NMDAR encephalitis during pregnancy combined with two antibodies positive

2021 ◽  
Author(s):  
Hong Liu ◽  
Xiu Chen
Keyword(s):  
Case Report ◽  
Pregnant Woman ◽  
Young Women ◽  
Psychiatric Symptoms ◽  
Review Of The Literature ◽  
Double Antibody ◽  
Aspartate Receptor ◽  
Nmdar Encephalitis ◽  
Surface Antibody

AbstractAnti-N-methyl-d-aspartate receptor (NMDAR) encephalitis is an autoimmune synaptic encephalitis likely mediated by neuronal surface antibody. Clinically, it is characterized by a variety of neurological and psychiatric symptoms, predominantly affecting young women. Recurrent anti-NMDAR cases combined with double-antibody positive during pregnancy have not been reported. We report a 19-year-old pregnant woman with recurrent anti-NMDAR encephalitis and double-antibody positive. Through our case report and a review of the literature, we hope to heighten an awareness of anti-NMDAR encephalitis, particularly in a pregnant setting.

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