scholarly journals NATURAL PRODUCTS IN TREATMENT OF ENCEPHALITIS: A REVIEW

2021 ◽  
Vol 21 (no 1) ◽  
Author(s):  
Danishpreet Kaur Takhar ◽  
Mukta Gupta
Keyword(s):  
Natural Products ◽  
Nmda Receptor ◽  
Plasma Exchange ◽  
Intravenous Immunoglobulin ◽  
Psychotic Disorders ◽  
Treatment Options ◽  
Therapeutic Approaches ◽  
Nmda Receptor Encephalitis ◽  
Aspartate Receptor

Brain on fire, an unusual phrase used for the deadliest autoimmune ailment, called anti-NMDA (N-methyl-D-aspartate) receptor encephalitis, characterizing extreme psychiatric and neurotic signs. Though being the deadliest one, still it can be treated with the help of various therapeutic approaches such as Corticosteroids, Intravenous immunoglobulin (IVIG) and plasmapheresis or plasma exchange. Although the prevalence of encephalitis can be observed in both the sexes, however the majority of ailment (95%) is seen in women with teratoma ovaries or different neoplasms. Recognition of nti-NMDA receptor encephalitis could be very essential to avoid any misconception regarding incorrect interpretation of various psychotic disorders. However, various treatment options are available still further investigation should be required to carried out to find out other clinically beneficial drugs.

Anti-NMDA Receptor Encephalitis: Efficacy of Treatment for Male Patients and miRNA Biomarker

2020 ◽  
Vol 27 (24) ◽  
pp. 4138-4151 ◽  
Author(s):  
Hsiuying Wang
Keyword(s):  
Nmda Receptor ◽  
Plasma Exchange ◽  
Intravenous Immunoglobulin ◽  
Treatment Efficacy ◽  
Efficacy Rate ◽  
Hierarchical Tree ◽  
Female Patients ◽  
Nmda Receptor Encephalitis ◽  
Male Patients ◽  
Tree Method

Background: Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is an acute form of encephalitis. Treatments for the anti-NMDA receptor encephalitis usually include steroids, intravenous immunoglobulin, plasma exchange, plasmapheresis, rituximab, cyclophosphamide and tumor resection. Objective: We aimed to compare the efficacy of the treatments including intravenous immunoglobulin, plasma exchange, plasmapheresis, rituximab or cyclophosphamide for male anti- NMDA receptor encephalitis patients without tumor and to discuss potential biomarkers for this disease. Method: The Fisher exact test and the contingency table analysis were used to analyze the treatment efficacy for 43 male and 76 female patients. In addition, a hierarchical tree method was adopted to analyze the difference in the treatment efficacy between male and female patients. Results: The p-values of testing whether the efficacy rate of plasmapheresis (or plasma exchange) for the male patient is greater than a threshold are significantly different from the pvalues for the other two treatments. In addition, the hierarchical tree method shows that the treatment strategy associating with early recovery is different for male and female patients. Conclusion: The results revealed that the efficacy rate of plasmapheresis (or plasma exchange) is not inferior to that of intravenous immunoglobulin and rituximab (or cyclophosphamide) for male patients without tumor. In addition, B-cell attracting C-X-C motif chemokine 13 (CXCL13) and microRNA let-7b have the potential to be the treatment response biomarkers for anti-NMDA receptor encephalitis. They may not be useful prognostic biomarkers for this encephalitis unless they are not biomarkers for other autoimmune encephalitides.

scholarly journals The Association Between Age and Prognosis in Patients Under 45 Years of Age With Anti-NMDA Receptor Encephalitis

2020 ◽  
Vol 11 ◽  
Author(s):  
Yueqian Sun ◽  
Guoping Ren ◽  
Jiechuan Ren ◽  
Wei Shan ◽  
Xiong Han ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Retrospective Study ◽  
Nmda Receptor ◽  
Confidence Interval ◽  
Modified Rankin Scale ◽  
Odds Ratios ◽  
Nmda Receptor Encephalitis ◽  
Aspartate Receptor ◽  
Multivariable Logistic Regression ◽  
Neurological Prognosis

This study aims to evaluate the association between age and prognosis in patients with anti-N-methyl-D-aspartate receptor encephalitis (anti-NMDARE) under the age of 45 years. A retrospective study was conducted in patients younger than 45 years diagnosed as anti-NMDARE in four hospitals in China. Age at admission was divided into four categories: <15, 15–24, 25–34, 35–45 years. Neurological prognosis was evaluated using modified Rankin Scale. Adjusted multivariable logistic regression was used to analyze the association. The multivariable-adjusted odds ratios (95% confidence interval) of prognosis in anti-NMDARE across the categories of age were as follows: in males, 1.00 (reference), 4.76 (0.39–58.76), 13.50 (0.79–230.40), and 8.81 (0.36–218.39) (P for trend = 0.171); in females, 1.00 (reference), 7.27 (0.36–146.19), 20.08 (1.09–370.39), and 54.41 (1.60–1,849.10) (P for trend = 0.01). We concluded that the increasing age was associated with a poorer prognosis of anti-NMDARE in females but not males.

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 Anti NMDA-receptor encephalitis: a severe case (34 year-old male) with psychotic disorders

2014 ◽  
Vol 14 (Suppl 7) ◽  
pp. P89
Author(s):  
Cleo Roşculeț ◽  
Andrei Rogoz ◽  
Ana Petrescu ◽  
Cătălin Apostolescu ◽  
Marius Radu ◽  
...  
Keyword(s):  
Nmda Receptor ◽  
Psychotic Disorders ◽  
Severe Case ◽  
Nmda Receptor Encephalitis

A 16-year-old girl with anti-NMDA-receptor encephalitis and family history of psychotic disorders

2015 ◽  
Vol 27 (6) ◽  
pp. 375-379 ◽  
Author(s):  
Neil Cleland ◽  
Samuel Lieblich ◽  
Martin Schalling ◽  
Christoffer Rahm
Keyword(s):  
Nmda Receptor ◽  
Family History ◽  
Psychotic Disorders ◽  
Autistic Traits ◽  
Personality Change ◽  
First Episode ◽  
Long Term Memory ◽  
Significant Family History ◽  
Nmda Receptor Encephalitis ◽  
History Of

BackgroundAutoimmune NMDA-R encephalitis (ANRE) shares clinical features with schizophrenia. Recent research also indicates that both disorders are associated with dysfunction of the N-Methyl-D-Aspartate glutamate receptors (NMDA-R) subunit 1.MethodsWe present the case of Ms A, 16 years old. Ms A presented with acute personality change, bizarre behaviour, delusional ideas and atypical seizures. She had a family history of psychotic disorders, and autistic traits diagnosed in childhood. She was initially diagnosed with a psychotic disorder. Delayed testing of CSF indicated ANRE. As the patient was a Jehovah's witness the treating team was unable to use gammaglobulin therapy; they instead relied on combined plasmapheresis and rituximab. To exclude the possibility that the affected members of this family shared a gene coding for an abnormal configuration of the NMDA receptor subunit 1 we sequenced the region of the GRIN1 gene in DNA extracted from blood in both Ms A and her grandmother.ResultsMs A’s condition improved dramatically, though her long-term memory is still demonstrably impaired. No genetic abnormality was detected.ConclusionsThis case emphasizes how important it is, for a first episode psychosis, to exclude ANRE and other autoimmune synaptic encephalitides, even in the face of significant family history, and if seronegative, the importance of testing for CSF autoantibodies.

scholarly journals Efficacy of Therapeutic Plasma Exchange in Patients with Severe Refractory Anti-NMDA Receptor Encephalitis

2019 ◽  
Vol 16 (3) ◽  
pp. 828-837 ◽  
Author(s):  
Yan Zhang ◽  
Gang Liu ◽  
Mengdi Jiang ◽  
Weibi Chen ◽  
Yingying Su
Keyword(s):  
Nmda Receptor ◽  
Plasma Exchange ◽  
Therapeutic Plasma Exchange ◽  
Nmda Receptor Encephalitis

scholarly journals Catatonia in Anti-N-Methyl-D-Aspartate (NMDA) Receptor Encephalitis Misdiagnosed as Schizophrenia

2020 ◽  
Vol 33 (3) ◽  
pp. 208
Author(s):  
André Ponte ◽  
Ana Brito ◽  
Camila Nóbrega ◽  
Sofia Pinheiro ◽  
João Gama Marques
Keyword(s):  
Psychotic Disorders ◽  
Neuropsychiatric Symptoms ◽  
Autoimmune Encephalitis ◽  
Poor Response ◽  
Diagnostic Investigation ◽  
Nmda Receptor Encephalitis ◽  
Aspartate Receptor ◽  
Previous Diagnosis ◽  
The Central Nervous System ◽  
Prompt Diagnosis

Anti-N-Mmethyl-D-aspartate receptor encephalitis is an autoimmune disease of the central nervous system with prominent neurologic and psychiatric features. Symptoms appear progressively and sometimes with an exclusively psychiatric initial presentation. The patient’s evaluation should be meticulous, and we should use all the diagnostic tests required for the exclusion of entities that can mimic this disease. We report the diagnostic investigation of a case of anti-N-methyl-D-aspartate receptor encephalitis in a patient with a previous diagnosis of schizophrenia with poor response to antipsychotics. The aim of this case report is to highlight the importance of close surveillance for neuropsychiatric symptoms, especially catatonia, and to recognize autoimmune encephalitis in the differential diagnosis of psychotic disorders with neurological symptoms and resistance or intolerance to antipsychotics. A prompt diagnosis will contribute to a faster onset of therapy and an overall improvement in prognosis.

scholarly journals What the acute physician needs to know about Anti-NMDA receptor encephalitis: two case presentations

2020 ◽  
Vol 19 (4) ◽  
pp. 244-250
Author(s):  
Stephanie Louise Gall ◽  
◽  
Sarah Mary Healy ◽  
Benedict Daniel Michael ◽  
Vicky Anne Price ◽  
...  
Keyword(s):  
Nmda Receptor ◽  
Case Reports ◽  
Antibody Testing ◽  
Medical Unit ◽  
Nmda Receptor Encephalitis ◽  
Acute Medical Unit ◽  
Aspartate Receptor ◽  
Nmdar Encephalitis ◽  
Case Presentations

These case reports look at two patients with anti-N-methyl-D-aspartate receptor (NMDAr) encephalitis presenting to the same acute medical unit within a month of each other. The following covers the characteristic signs, symptoms and timeline associated with this condition and discusses whether we should be sending CSF for anti-NMDAr antibody testing more readily.

scholarly journals A case of anti-NMDA receptor encephalitis with thymoma

2021 ◽  
Vol 6 (9) ◽  
Keyword(s):  
Nmda Receptor ◽  
Hormone Therapy ◽  
Clinical Characteristics ◽  
Treatment Process ◽  
Relevant Literature ◽  
Clinical Manifestations ◽  
Test Characteristics ◽  
Nmda Receptor Encephalitis ◽  
Aspartate Receptor ◽  
Treatment Plans

To explore the clinical characteristics, imaging examination, test characteristics, diagnostic ideas and treatment plans of anti-N-methyl-D aspartate receptor encephalitis, so as to better understand anti-NMAD receptor encephalitis. Methods: To analyze the diagnosis and treatment process of a case of anti-NMAD receptor encephalitis with thymoma admitted to the Department of Neurology of our hospital on May 31, 2021, and review the relevant literature. Results: In this article, the anti-NMAD encephalitis patients with pons as the main affected site also had thymoma, their disease progressed rapidly, clinical manifestations, imaging examinations were not typical, the effect of hormone therapy was not good, and the prognosis was poor

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