Anti-N-methyl-D-aspartate receptor encephalitis: a prospective study focused on cerebrospinal fluid and clinical symptoms
Background and objective To analyze the relationship between brain MRI, clinical symptoms, and cerebrospinal fluid (CSF) and to provide a reference for early diagnosis of anti- N -methyl-D-aspartate receptor (NMDAR) encephalitis. Materials and Methods A total of 62 patients with anti-NMDAR encephali...
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| Veröffentlicht in: | Neurological sciences 2020-11, Vol.41 (11), p.3255-3263 |
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| container_title | Neurological sciences |
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| creator | Wu, Shouyi Li, Huiqin Lian, Yajun Chen, Yuan Zheng, Yake Wang, Chengze Zhang, Qiaoman Huang, Zhi Mao, Zhengrong Pang, Kai |
| description | Background and objective
To analyze the relationship between brain MRI, clinical symptoms, and cerebrospinal fluid (CSF) and to provide a reference for early diagnosis of anti-
N
-methyl-D-aspartate receptor (NMDAR) encephalitis.
Materials and Methods
A total of 62 patients with anti-NMDAR encephalitis in Zhengzhou, China (2016–2018) were observed and registered prospectively. First, we analyzed the characteristics of clinical symptoms. Second, according to the disease duration, patients were divided into two groups, and then we analyzed the CSF features. In addition, they were divided into two groups according to the brain MRI, and then the CSF features were analyzed. Finally, the characteristics of cerebrospinal fluid in patients with seizure as the initial symptom were analyzed.
Results
Seizure presents as the initial symptom in 14 patients (22.5%), including 11 males (78.57%). The proportion and concentration of CSF total protein abnormalities in the early stage group were significantly higher than those in the middle and late group (
P
< 0.05). The total protein concentration in the abnormal brain MRI group was significantly higher than that in the normal MRI group (
P
< 0.05).
Conclusion
Anti-NMDAR encephalitis should be suspected, when male patients complain of seizure as an initial symptom and have simultaneously had headaches or fever prior to onset. The sensitivity of anti-NMDAR antibody is higher in CSF than in serum. Total CSF protein is more prone to elevation in the middle and late stages of anti-NMDAR encephalitis. Brain MRI abnormalities with anti-NMDAR encephalitis are related to the total protein concentration of CSF, which may be related to the disease duration. |
| doi_str_mv | 10.1007/s10072-020-04451-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2402422509</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2402422509</sourcerecordid><originalsourceid>FETCH-LOGICAL-c347t-fe4ebb2b9937f61743ac1525f7b49cd29e6df0c5fddb2bf6141d1caae4f090da3</originalsourceid><addsrcrecordid>eNp9kE1vVSEQhonR2Nr6B1wYlt2gA4fTU7prWr-SG93YNeHAYGnOlwzH5Px7ud7bLt3ABJ55M_Mw9k7CBwnQfaT9qQQoEKB1KwW8YKeyNSAa3V29PNbyqtMn7A3RIwBILZvX7KRRjTGmladsu5lKEt_FiOVhG8SdcLS4XFxBntHjUubMcarFgxtSSXTNHV_yTAv6kv4gp7KGjcfZr4SBzxP3mLHfA2lyA4_DmgJ3U-B-SFPy9Ym2saaOdM5eRTcQvj3eZ-z-86eft1_F7seXb7c3O-HrFkVE1Nj3qjem6eKl7HTjvGxVG7teGx-UwcsQwbcxhEpVQssgvXOoIxgIrjljF4fcOvbvFanYMZHHYXATzitZpUFppVowFVUH1NcFKGO0S06jy5uVYPey7UG5rcrtP-UWatP7Y_7ajxieW54cV6A5AFS_pl-Y7eO85mqH_hf7FzxKj4g</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2402422509</pqid></control><display><type>article</type><title>Anti-N-methyl-D-aspartate receptor encephalitis: a prospective study focused on cerebrospinal fluid and clinical symptoms</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Wu, Shouyi ; Li, Huiqin ; Lian, Yajun ; Chen, Yuan ; Zheng, Yake ; Wang, Chengze ; Zhang, Qiaoman ; Huang, Zhi ; Mao, Zhengrong ; Pang, Kai</creator><creatorcontrib>Wu, Shouyi ; Li, Huiqin ; Lian, Yajun ; Chen, Yuan ; Zheng, Yake ; Wang, Chengze ; Zhang, Qiaoman ; Huang, Zhi ; Mao, Zhengrong ; Pang, Kai</creatorcontrib><description>Background and objective
To analyze the relationship between brain MRI, clinical symptoms, and cerebrospinal fluid (CSF) and to provide a reference for early diagnosis of anti-
N
-methyl-D-aspartate receptor (NMDAR) encephalitis.
Materials and Methods
A total of 62 patients with anti-NMDAR encephalitis in Zhengzhou, China (2016–2018) were observed and registered prospectively. First, we analyzed the characteristics of clinical symptoms. Second, according to the disease duration, patients were divided into two groups, and then we analyzed the CSF features. In addition, they were divided into two groups according to the brain MRI, and then the CSF features were analyzed. Finally, the characteristics of cerebrospinal fluid in patients with seizure as the initial symptom were analyzed.
Results
Seizure presents as the initial symptom in 14 patients (22.5%), including 11 males (78.57%). The proportion and concentration of CSF total protein abnormalities in the early stage group were significantly higher than those in the middle and late group (
P
< 0.05). The total protein concentration in the abnormal brain MRI group was significantly higher than that in the normal MRI group (
P
< 0.05).
Conclusion
Anti-NMDAR encephalitis should be suspected, when male patients complain of seizure as an initial symptom and have simultaneously had headaches or fever prior to onset. The sensitivity of anti-NMDAR antibody is higher in CSF than in serum. Total CSF protein is more prone to elevation in the middle and late stages of anti-NMDAR encephalitis. Brain MRI abnormalities with anti-NMDAR encephalitis are related to the total protein concentration of CSF, which may be related to the disease duration.</description><identifier>ISSN: 1590-1874</identifier><identifier>EISSN: 1590-3478</identifier><identifier>DOI: 10.1007/s10072-020-04451-0</identifier><identifier>PMID: 32399951</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Anti-N-Methyl-D-Aspartate Receptor Encephalitis - complications ; Anti-N-Methyl-D-Aspartate Receptor Encephalitis - diagnostic imaging ; China ; Humans ; Magnetic Resonance Imaging ; Male ; Medicine ; Medicine & Public Health ; Neurology ; Neuroradiology ; Neurosurgery ; Original Article ; Prospective Studies ; Psychiatry ; Seizures</subject><ispartof>Neurological sciences, 2020-11, Vol.41 (11), p.3255-3263</ispartof><rights>Fondazione Società Italiana di Neurologia 2020</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c347t-fe4ebb2b9937f61743ac1525f7b49cd29e6df0c5fddb2bf6141d1caae4f090da3</citedby><cites>FETCH-LOGICAL-c347t-fe4ebb2b9937f61743ac1525f7b49cd29e6df0c5fddb2bf6141d1caae4f090da3</cites><orcidid>0000-0002-8520-9879</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10072-020-04451-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10072-020-04451-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32399951$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wu, Shouyi</creatorcontrib><creatorcontrib>Li, Huiqin</creatorcontrib><creatorcontrib>Lian, Yajun</creatorcontrib><creatorcontrib>Chen, Yuan</creatorcontrib><creatorcontrib>Zheng, Yake</creatorcontrib><creatorcontrib>Wang, Chengze</creatorcontrib><creatorcontrib>Zhang, Qiaoman</creatorcontrib><creatorcontrib>Huang, Zhi</creatorcontrib><creatorcontrib>Mao, Zhengrong</creatorcontrib><creatorcontrib>Pang, Kai</creatorcontrib><title>Anti-N-methyl-D-aspartate receptor encephalitis: a prospective study focused on cerebrospinal fluid and clinical symptoms</title><title>Neurological sciences</title><addtitle>Neurol Sci</addtitle><addtitle>Neurol Sci</addtitle><description>Background and objective
To analyze the relationship between brain MRI, clinical symptoms, and cerebrospinal fluid (CSF) and to provide a reference for early diagnosis of anti-
N
-methyl-D-aspartate receptor (NMDAR) encephalitis.
Materials and Methods
A total of 62 patients with anti-NMDAR encephalitis in Zhengzhou, China (2016–2018) were observed and registered prospectively. First, we analyzed the characteristics of clinical symptoms. Second, according to the disease duration, patients were divided into two groups, and then we analyzed the CSF features. In addition, they were divided into two groups according to the brain MRI, and then the CSF features were analyzed. Finally, the characteristics of cerebrospinal fluid in patients with seizure as the initial symptom were analyzed.
Results
Seizure presents as the initial symptom in 14 patients (22.5%), including 11 males (78.57%). The proportion and concentration of CSF total protein abnormalities in the early stage group were significantly higher than those in the middle and late group (
P
< 0.05). The total protein concentration in the abnormal brain MRI group was significantly higher than that in the normal MRI group (
P
< 0.05).
Conclusion
Anti-NMDAR encephalitis should be suspected, when male patients complain of seizure as an initial symptom and have simultaneously had headaches or fever prior to onset. The sensitivity of anti-NMDAR antibody is higher in CSF than in serum. Total CSF protein is more prone to elevation in the middle and late stages of anti-NMDAR encephalitis. Brain MRI abnormalities with anti-NMDAR encephalitis are related to the total protein concentration of CSF, which may be related to the disease duration.</description><subject>Anti-N-Methyl-D-Aspartate Receptor Encephalitis - complications</subject><subject>Anti-N-Methyl-D-Aspartate Receptor Encephalitis - diagnostic imaging</subject><subject>China</subject><subject>Humans</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neurology</subject><subject>Neuroradiology</subject><subject>Neurosurgery</subject><subject>Original Article</subject><subject>Prospective Studies</subject><subject>Psychiatry</subject><subject>Seizures</subject><issn>1590-1874</issn><issn>1590-3478</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1vVSEQhonR2Nr6B1wYlt2gA4fTU7prWr-SG93YNeHAYGnOlwzH5Px7ud7bLt3ABJ55M_Mw9k7CBwnQfaT9qQQoEKB1KwW8YKeyNSAa3V29PNbyqtMn7A3RIwBILZvX7KRRjTGmladsu5lKEt_FiOVhG8SdcLS4XFxBntHjUubMcarFgxtSSXTNHV_yTAv6kv4gp7KGjcfZr4SBzxP3mLHfA2lyA4_DmgJ3U-B-SFPy9Ym2saaOdM5eRTcQvj3eZ-z-86eft1_F7seXb7c3O-HrFkVE1Nj3qjem6eKl7HTjvGxVG7teGx-UwcsQwbcxhEpVQssgvXOoIxgIrjljF4fcOvbvFanYMZHHYXATzitZpUFppVowFVUH1NcFKGO0S06jy5uVYPey7UG5rcrtP-UWatP7Y_7ajxieW54cV6A5AFS_pl-Y7eO85mqH_hf7FzxKj4g</recordid><startdate>20201101</startdate><enddate>20201101</enddate><creator>Wu, Shouyi</creator><creator>Li, Huiqin</creator><creator>Lian, Yajun</creator><creator>Chen, Yuan</creator><creator>Zheng, Yake</creator><creator>Wang, Chengze</creator><creator>Zhang, Qiaoman</creator><creator>Huang, Zhi</creator><creator>Mao, Zhengrong</creator><creator>Pang, Kai</creator><general>Springer International Publishing</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8520-9879</orcidid></search><sort><creationdate>20201101</creationdate><title>Anti-N-methyl-D-aspartate receptor encephalitis: a prospective study focused on cerebrospinal fluid and clinical symptoms</title><author>Wu, Shouyi ; Li, Huiqin ; Lian, Yajun ; Chen, Yuan ; Zheng, Yake ; Wang, Chengze ; Zhang, Qiaoman ; Huang, Zhi ; Mao, Zhengrong ; Pang, Kai</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c347t-fe4ebb2b9937f61743ac1525f7b49cd29e6df0c5fddb2bf6141d1caae4f090da3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Anti-N-Methyl-D-Aspartate Receptor Encephalitis - complications</topic><topic>Anti-N-Methyl-D-Aspartate Receptor Encephalitis - diagnostic imaging</topic><topic>China</topic><topic>Humans</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neurology</topic><topic>Neuroradiology</topic><topic>Neurosurgery</topic><topic>Original Article</topic><topic>Prospective Studies</topic><topic>Psychiatry</topic><topic>Seizures</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wu, Shouyi</creatorcontrib><creatorcontrib>Li, Huiqin</creatorcontrib><creatorcontrib>Lian, Yajun</creatorcontrib><creatorcontrib>Chen, Yuan</creatorcontrib><creatorcontrib>Zheng, Yake</creatorcontrib><creatorcontrib>Wang, Chengze</creatorcontrib><creatorcontrib>Zhang, Qiaoman</creatorcontrib><creatorcontrib>Huang, Zhi</creatorcontrib><creatorcontrib>Mao, Zhengrong</creatorcontrib><creatorcontrib>Pang, Kai</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Neurological sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wu, Shouyi</au><au>Li, Huiqin</au><au>Lian, Yajun</au><au>Chen, Yuan</au><au>Zheng, Yake</au><au>Wang, Chengze</au><au>Zhang, Qiaoman</au><au>Huang, Zhi</au><au>Mao, Zhengrong</au><au>Pang, Kai</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Anti-N-methyl-D-aspartate receptor encephalitis: a prospective study focused on cerebrospinal fluid and clinical symptoms</atitle><jtitle>Neurological sciences</jtitle><stitle>Neurol Sci</stitle><addtitle>Neurol Sci</addtitle><date>2020-11-01</date><risdate>2020</risdate><volume>41</volume><issue>11</issue><spage>3255</spage><epage>3263</epage><pages>3255-3263</pages><issn>1590-1874</issn><eissn>1590-3478</eissn><abstract>Background and objective
To analyze the relationship between brain MRI, clinical symptoms, and cerebrospinal fluid (CSF) and to provide a reference for early diagnosis of anti-
N
-methyl-D-aspartate receptor (NMDAR) encephalitis.
Materials and Methods
A total of 62 patients with anti-NMDAR encephalitis in Zhengzhou, China (2016–2018) were observed and registered prospectively. First, we analyzed the characteristics of clinical symptoms. Second, according to the disease duration, patients were divided into two groups, and then we analyzed the CSF features. In addition, they were divided into two groups according to the brain MRI, and then the CSF features were analyzed. Finally, the characteristics of cerebrospinal fluid in patients with seizure as the initial symptom were analyzed.
Results
Seizure presents as the initial symptom in 14 patients (22.5%), including 11 males (78.57%). The proportion and concentration of CSF total protein abnormalities in the early stage group were significantly higher than those in the middle and late group (
P
< 0.05). The total protein concentration in the abnormal brain MRI group was significantly higher than that in the normal MRI group (
P
< 0.05).
Conclusion
Anti-NMDAR encephalitis should be suspected, when male patients complain of seizure as an initial symptom and have simultaneously had headaches or fever prior to onset. The sensitivity of anti-NMDAR antibody is higher in CSF than in serum. Total CSF protein is more prone to elevation in the middle and late stages of anti-NMDAR encephalitis. Brain MRI abnormalities with anti-NMDAR encephalitis are related to the total protein concentration of CSF, which may be related to the disease duration.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>32399951</pmid><doi>10.1007/s10072-020-04451-0</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-8520-9879</orcidid></addata></record> |
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| ispartof | Neurological sciences, 2020-11, Vol.41 (11), p.3255-3263 |
| issn | 1590-1874 1590-3478 |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Anti-N-Methyl-D-Aspartate Receptor Encephalitis - complications Anti-N-Methyl-D-Aspartate Receptor Encephalitis - diagnostic imaging China Humans Magnetic Resonance Imaging Male Medicine Medicine & Public Health Neurology Neuroradiology Neurosurgery Original Article Prospective Studies Psychiatry Seizures |
| title | Anti-N-methyl-D-aspartate receptor encephalitis: a prospective study focused on cerebrospinal fluid and clinical symptoms |
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