Differentiating Anti-NMDA receptor encephalitis from other diseases: Difference between revisions

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==Overview==
==Overview==
In the differential diagnosis of anti-NMDA encephalitis, other autoimmune encephalitides with specific antibody associations should be considered, including those associated with antibodies against AMPA receptors, GABA-B receptors, LGI1, Caspr2, and MOG. Clinical and serological evaluations are crucial for accurate diagnosis and appropriate management.


==Differentiating Anti-NMDA Receptor Encephalitis from other Diseases==
==Differentiating Anti-NMDA Receptor Encephalitis from other Diseases==
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ocb: oligoclonal bands; EEG: electroencephalograph; NMDA: N-methyl-D-aspartate; AMPA: α-amino-3-hydroxy-5-methyl-4-isoxazol-propionic acid; GABA:
ocb: oligoclonal bands; EEG: electroencephalograph; NMDA: N-methyl-D-aspartate; AMPA: α-amino-3-hydroxy-5-methyl-4-isoxazol-propionic acid; GABA:
γ-amino-butyric acid receptor; CASPR2: contactin-associated protein-like 2; Lgi1: leucine-rich, glioma-inactivated 1; mGluR5: metabotrophic glutamate receptor 5.
γ-amino-butyric acid receptor; CASPR2: contactin-associated protein-like 2; Lgi1: leucine-rich, glioma-inactivated 1; mGluR5: metabotrophic glutamate receptor 5.
Other etiologies causing Anti NMDA encephalitis like features
{| class="wikitable"
|-
! Differential diagnosis
|-
| Bacterial and viral infections of the brain
| Herpes simplex virus type 1, Human herpes virus type 6, Enterovirus, Mycoplasma
 
|-
| Autoimmune-associated encephalitis
| PANDAS, Sydenham chorea, Hashimoto encephalopathy, Rasmussen encephalitis, Encephalitis lethargica
|-
| Autoimmune synaptic receptor encephalitides
| Neuronal antibodies to GABA, AMPA, and LGI1receptors
|-
| CNS vasculitis
| Primary CNS angiitis, Secondary (due to chronic infection, inflammatory processes)
|-
|Demyelinating disorders
|Acute disseminated encephalomyelitis, Neuromyelitis optica
|-
|Medication Overdose
|Ketamine, Phencyclidine
|}


==References==
==References==
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[[Category:Rheumatology]]
[[Category:Rheumatology]]
[[Category:Disease]]
[[Category:Disease]]
 
<ref name="pmid29955485">{{cite journal| author=Nichols TA| title=Anti-NMDA receptor encephalitis: An emerging differential diagnosis in the psychiatric community. | journal=Ment Health Clin | year= 2016 | volume= 6 | issue= 6 | pages= 297-303 | pmid=29955485 | doi=10.9740/mhc.2016.11.297 | pmc=6007532 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29955485  }} </ref>
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Latest revision as of 07:27, 13 May 2023

Anti-NMDA receptor encephalitis Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ;AE Dheeraj Makkar, M.D.[2]

Overview

In the differential diagnosis of anti-NMDA encephalitis, other autoimmune encephalitides with specific antibody associations should be considered, including those associated with antibodies against AMPA receptors, GABA-B receptors, LGI1, Caspr2, and MOG. Clinical and serological evaluations are crucial for accurate diagnosis and appropriate management.

Differentiating Anti-NMDA Receptor Encephalitis from other Diseases

Antigen NMDA receptor NR1 Lgil CASPR2 AMPA receptor GABA B receptor Glycine receptor MgluR5


Age(median)/gender female : male 0·6–85 (21) 4:1 30–80 (60) 1:2 46–77 (60) 1:4 38–87 (60) 9:1 24–75 (62) 1:1 5–69 (43) 6:5 46, 15 1:1
Clinical syndrome 1.Prodromal Syndrome

2. Psychiatric Syndrome, seizures, amnesia 3.Movement disorders catatonia, autonomic instability,

Limbic encephalitis, tonic or facio-brachial dystonic seizures,

myoclonus


Morvan Syndrome, encephalitis, neuromyotonia Limbic encephalitis, psychiatric syndrome Limbic encephalitis Encephalomyelitis with rigidity and myoclonus, hyperekplexia, stiff-person syndrome,

(retinopathy)

Limbic encephalitis, myoclonus
MRI T2/FLAIR hyperintensities, medial temporal 25% 80% 40% 90% 70% 10% 50%
CSF pleocytosis or Oligoclonal Bands 95% 40% 25% 90% 90% some oligoclonal bands 2/2 only cases reported and present in them


ocb: oligoclonal bands; EEG: electroencephalograph; NMDA: N-methyl-D-aspartate; AMPA: α-amino-3-hydroxy-5-methyl-4-isoxazol-propionic acid; GABA: γ-amino-butyric acid receptor; CASPR2: contactin-associated protein-like 2; Lgi1: leucine-rich, glioma-inactivated 1; mGluR5: metabotrophic glutamate receptor 5.

Other etiologies causing Anti NMDA encephalitis like features

Differential diagnosis


Bacterial and viral infections of the brain Herpes simplex virus type 1, Human herpes virus type 6, Enterovirus, Mycoplasma


Autoimmune-associated encephalitis PANDAS, Sydenham chorea, Hashimoto encephalopathy, Rasmussen encephalitis, Encephalitis lethargica


Autoimmune synaptic receptor encephalitides Neuronal antibodies to GABA, AMPA, and LGI1receptors
CNS vasculitis Primary CNS angiitis, Secondary (due to chronic infection, inflammatory processes)
Demyelinating disorders Acute disseminated encephalomyelitis, Neuromyelitis optica
Medication Overdose Ketamine, Phencyclidine

References

[1] Template:WH Template:WS

  1. Nichols TA (2016). "Anti-NMDA receptor encephalitis: An emerging differential diagnosis in the psychiatric community". Ment Health Clin. 6 (6): 297–303. doi:10.9740/mhc.2016.11.297. PMC 6007532. PMID 29955485.